Stress urinary incontinence occurs when there is leakage of urine as a result of a sudden increase in abdominal pressure. This sudden increase can be caused by coughing, laughing, sneezing, jumping, exercising, walking or sudden movement. Urge incontinence occurs when there is leakage of urine associated with a sudden strong urge to urinate. When this occurs, the urge to urinate cannot be suppressed and urine is forced out before the toilet can be reached. In many cases a woman may experience both types of incontinence. The term “mixed incontinence” is used to describe this problem.
Urinary incontinence occurs in 35-60% of women. The prevalence is higher in older women and in women who have delivered their children naturally. The many shelves of protective pads and undergarments seen in the grocery stores, supercenters and pharmacies are a testimony to the extent of this problem.
Major risk factors for this condition are childbirth, pelvic trauma, and obesity. This problem can be exacerbated by muscle disuse, certain medical conditions, aging, and weight gain. The muscles, nerves and connective tissue of the pelvis are damaged at the time of childbirth or surgery resulting in inadequate support of the pelvic floor and poor control over bladder function.
The decision to seek care is usually dependent on the severity of the problem as well as its impact on one’s quality of life. A sedentary woman may have infrequent episodes of stress urinary incontinence but a woman who exercises may have many more occurrences. This woman can either elect to stop exercising or seek care. A woman who stays at home most of the time can empty her bladder frequently, thereby avoiding episodes of urinary urgency. On the other hand, a woman who is socially active and always on the go may not have the opportunity to urinate more frequently thus she is more likely to experience episodes of urge incontinence. She can elect to curb her social life or seek care.
A comprehensive evaluation is required to identify the problem and to make recommendations for treatment. Urogynecologists or Female Pelvic Medicine Specialists are clinicians trained to care for women with pelvic floor disorders such as urinary incontinence. The specialty is now referred to as Female Pelvic Medicine and Reconstructive Surgery. Certain Gynecologist and Urologist also have an interest in caring for women with urinary incontinence. It is important to identify a specialist who cares for a large volume of women with these problems so that you can be provided with a thorough evaluation and offered a full range of treatment options.
Treatment options may include medication, dietary changes, pelvic floor muscle rehabilitation, in-office procedures or minimally invasive surgical procedures. The success rates for some procedures can be as high as 92% and the recovery period as short as a few days to 2 weeks. The complication rates are quite low and the hospitalization period as short as a few hours to 1 day.
Urinary incontinence is a prevalent problem that can interfere with the quality of life. Effective treatment options are available and should be sought so you can continue to lead a productive and fulfilling life.
I hope this article has provided you with information that will help you make wise choices, so you may:
Live healthy, live well and live long!
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