Just for Her: Afraid to sneeze?
By Timothy J. Ramsden, MD
Cascade Valley Women's Health
Your mother or close friend may have told you, leaking urine is just part of getting older. As much as we may respect their opinion, they are wrong. While urinary incontinence (UI) is not a life-threatening condition, it may cause women to limit social and physical activities, sometimes even leading to social isolation and depression. UI has been linked to loss of independence and decreasing quality of life.
Medical providers often do not recognize UI, and it is definitely underreported by embarrassed patients. It has been estimated only one-quarter to one-half of those suffering from this condition seek treatment, yet one-third of women over forty suffer with it.
Aging, increased number of vaginal births, obesity, and having a hysterectomy all increase your chances of developing UI. While other factors have been associated with incontinence, such as Chronic Obstructive Pulmonary Disease (COPD) and smoking, those are not definite. There is a clear link between the numbers of babies you have, up to four births. Also, if instruments are used--especially forceps--there is an even greater chance of developing UI. You have a 36% risk factor with instrumented vaginal delivery, versus twenty-one percent for spontaneous vaginal delivery. A cesarean section birth does not appear to increase the prevalence of incontinence. If you experience loss of urine during pregnancy you will usually regain continence within nine to twelve months of giving birth.
There are three main types of UI: Stress Urinary Incontinence (SUI), Urge Incontinence and Mixed Incontinence.
SUI is the most common type in women under age sixty and affects half of all women who experience incontinence. It occurs when the pressure in your bladder is too high for it to not allow urine leakage. There are two main causes of SUI. Both lead to the same symptoms of urine leakage with common events such as coughing, sneezing, laughing, lifting heavy objects, intercourse, and sometimes just rising from a chair.
An overactive bladder causes urge incontinence. A television commercial best describes the feeling you may experience. "Gotta Go, Gotta Go, Gotta Go!" Many times women say they experience this feeling when running their hands under water, washing dishes, driving up to their home, or just by opening the door to their home.The third type of incontinence is Mixed Incontinence. Literally, it is a mixture of stress and urge incontinence. A great majority of women describe the symptoms of Mixed Incontinence, but on testing are found to have SUI. The good news is, there are many available treatments. There are non-surgical, pharmacological, and surgical treatments for urinary incontinence. Surgical treatments are only used for stress incontinence.
Behavioral modification, such as bladder training, scheduled toileting, and pelvic muscle exercises, are the mainstays of non-surgical therapies.
Currently, prescription therapies are only effective for urge incontinence. However, a drug being tested is reportedly effective for stress as well as urge incontinence.
Last, but by far from least, are surgical treatments available for SUI. Although surgical therapy is not for everyone, nor for every type of incontinence, several options give up to an 85 to 90 percent chance of curing your incontinence problem. Most of these procedures can be done on an outpatient basis with a relatively short recovery time.
As you can see, if you have incontinence, you are not alone. Help is readily available with numerous treatment options. Stop letting your bladder run your life, tell your health provider that you are tired of being wet. Get dry, get out of the house, and start enjoying all that life has to offer.
Disclaimer: This information is provided for educational purposes only. It should not replace a visit with your health care professional. Call your doctor if you need more information or have additional questions.