Have you ever lost a
few drops of urine while coughing or running, or didn't quite
make it to the bathroom in time? You may be one of the millions of
American women who suffer from urinary incontinence, an involuntary
loss of urine that while not a serious health problem, can be very
While women experience urinary incontinence
twice as often as men and it becomes more prevalent with age, the
condition is very treatable once diagnosed. According to Heather
Wargo, MD, a urologist on staff at Lourdes Medical Center of Burlington County, there
are multiple possible reasons for urinary incontinence, but two
- Stress incontinence
occurs when you sneeze, cough, laugh, jog or do other things that
put pressure on your bladder. It is the most common type of
bladder control problem in women.
incontinence happens when you have a strong need to urinate but can't
get to the bathroom in time. This can occur even when the bladder
is holding just a small amount of urine, and without warning.
Overactive bladder is a kind of urge incontinence, but not everyone
with overactive bladder leaks urine.
Pregnancy, childbirth, menopause, surgery and weight gain are among
the physical changes that can cause stress incontinence.
you have good pelvic floor support, the elevated abdominal
pressures that occur when you perform activities such as coughing and
heavy lifting are exerted equally on your bladder and your urethra.
However, if the pelvic floor muscles, vagina and ligaments weaken,
they can no longer support your bladder and urethra. The elevated
pressures are no longer exerted equally," Dr. Wargo explained.
"The urethral sphincter muscles may not be strong enough to overcome
the rise in pressure and keep the urethra squeezed tightly shut,
allowing urine to leak during times of physical stress. In some
people, the urethral sphincter itself is deficient and is no longer
able to stay tightly closed."
Stress incontinence also can
worsen during low estrogen states, such as during menopause or
even the week before menstruation, as reduced estrogen levels may
lead to lower muscular pressure around the
A new study in Obstetrics &
Gynecology shows that shedding just a little weight may greatly reduce
Researchers studied the
effects of weight change in 338 overweight or obese women with urinary incontinence. All had a
body mass index between 25 and 50 and were provided information on
healthy lifestyles or enrolled in a weight-loss program.
After 18 months, the results showed major changes for women who
lost just 5 to 10 percent of their initial body weight. These
women were up to four times more likely than women who gained weight
to report significant improvement in their symptoms. Many of them
reduced incontinence episodes each week by 70 percent or more.
These results were true even among women who weighed the most and
struggled with the most frequent symptoms.
For help, talk
with your doctor. He or she can help you develop a weight-loss plan
that's right for you. For weight-loss tips, visit http://win.niddk.nih.gov/publications/for_life.htm.
Other treatment options for urinary
- Training yourself to use the
bathroom at regularly timed intervals.
- Kegel exercises to
strengthen the pelvic floor muscles. These exercises help many
people improve bladder control in several weeks.
of caffeine, smoking, alcohol and other bladder
- Medicines to block the nerve signals that cause frequent
urination and urgency.
- Stimulation of nerves to the bladder
leaving the spine (neuromodulation). While not for everyone, this
therapy has proven effective for some who have not responded to
behavioral treatments and medications.
There are two
types of surgical options for stress urinary
- Injection of collagen or some other material into the
peri-urethral tissues. This is called urethral bulking and works to
prevent urine from leaking out of the urethra by narrowing the
- Surgery to support the urethra, such as placing a
urethral sling in the space between the urethra and vagina. The
sling may be composed of synthetic mesh material, the patient's own
tissues or tissue from a donor. "The sling resembles a hammock and
provides the correct amount of support for the urethra," Dr. Wargo
"Women should not have to live with urinary
incontinence," she added. "There are many treatment options
available. Speak with your physician to find the right one."