Is this woman running your life?
If your busy schedule is interrupted by frequent trips to the bathroom, you're
not alone. Urinary incontinence affects about 26 million Americans. It's estimated
that women make up 80 percent of this number, and that number may be higher
since many women are too embarrassed to discuss the problem with their doctor.
"Urinary incontinence, an involuntary loss of urine, is a common problem
for many women," says Randy Ackerman, MD, Virtua urologist. "The good
news is there are excellent treatments available to help."
Here are the most common types of urinary incontinence, and available
No coughing, sneezing or laughing matter
Stress incontinence often occurs while coughing, sneezing, laughing, or exercising
because pressure is applied to the bladder. "Stress incontinence in women can occur
when the pelvic floor muscles that control urine flow are weakened from pregnancy,
childbirth, or obesity, or because of age or genetic predisposition," says Warren
Brandwine, DO, MBE, Virtua obstetrician and gynecologist.
Kegel exercises, used to treat stress incontinence, strengthen the
pelvic floor muscles that support the urethra and bladder. They are often
combined with computer monitoring (biofeedback) to ensure they are
being done effectively. "Kegel exercises can help, but very seldom cure
incontinence," notes Dr. Brandwine.
For those women who need a more advanced approach, urethral sling
surgery offers a 95 to 98 percent success rate in women. The sling is a small
piece of synthetic material that acts like a hammock to support and stabilize
the urethra. "The sling is inserted through a one-inch vaginal incision, and
it's held in place by scar tissue that forms around it as the body heals," says
Dr. Ackerman. The surgery takes about 30 minutes, and the patient only
needs local anesthesia and mild sedation.
Gotta go, gotta go, gotta go right now
Urge incontinence is the involuntary loss of urine that occurs when the
bladder contracts inappropriately. It's considered overactive bladder when it's
accompanied by an urge to urinate and a "gotta-go-now" urgency that
would make a person run to the bathroom multiple times throughout the
day and night.
"Overactive bladder may be attributed to lifestyle choices like drinking
too many liquids or waiting too long to urinate when you're busy or on a
long car trip," says Dr. Brandwine.
Medications that relax the bladder are very effective in treating the
urge to urinate. For patients who don't respond to medical treatment,
there's another option that uses a "pacemaker" to regulate bladder function.
Dr. Ackerman explains: "The device is implanted inside the body and
sends electrical signals to help regulate bladder control."
The important thing to remember is that you don't have to live with
urinary incontinence. "Don't let embarrassment keep you from seeking
help," says Dr. Ackerman.