Stress Incontinence

Do you lose urine when you laugh, cough or sneeze? Do you have to wear pads or panty liners when you work out?  You are not alone.  Urinary leakage is very common. Some studies show that nearly 35% of women experience urinary leakage.. This is especially common after having children and for some it gets worse over time. Luckily, there are many options available to diagnose and treat the causes of urinary incontinence.

The first step is to realize you do not have to “put up with” this symptom.  Although common, it is not a “normal” part of life.  Next, talk to your healthcare provider. They will ask you questions to get a better handle on what is going on. Does urine only leak out when you exercise? Does it happen throughout the day?  Do you get urges and then you can’t make it to the bathroom in time? Does it happen right when you stand up after urinating? How many times do you have to get up at night? The answers to the details of your symptoms will help narrow down the possible causes.. The most common kind of urinary leakage is called stress incontinence. That is when a little bit of urine (or sometimes a lot of urine) leaks out whenever stress is applied to your bladder. That stress can be exercise, coughing, sneezing, laughing, sex, etc. The best way to diagnose stress incontinence is to undergo an office bladder evaluation.

A bladder evaluation is a quick in-office exam in which the provider fills your bladder through a catheter and then has you reproduce your symptoms. The angle that your pelvic floor makes when stress is applied to your bladder will also be measured.. After the bladder evaluation is completed your provider will be able to go through your possible treatment options. For some women, pelvic floor physical therapy is a great option. Others might benefit from medication.  And still others might opt for surgery. Ultimately, you get to choose what you want to do when it comes to your treatment. This is your health journey. We are here to support you with your health goals. By scheduling a bladder evaluation, you are not committing to a treatment, rather learning more about what is causing your urinary leakage and engaging in a conversation about what can be done about it. This appointment takes about 30 minutes, mostly consisting of conversation and understanding the procedure and the results.

As mentioned, one treatment option is physical therapy.  Appropriately done pelvic floor exercises have been shown to reduce the number of incontinence episodes.  Medical therapy is most useful for patients who have urgency symptoms but also often reduce stress incontinence too.  The surgical option is known as a bladder sling (aka “bladder lift”). Contrary to popular belief, during a bladder sling procedure, the bladder is not actually lifted. Instead, a sling is placed under the bladder neck to prevent it from dropping into your pelvis every time you jump, sneeze, laugh, or cough. This is a quick and safe procedure that can be done in an outpatient surgery center. The surgery has a high success rate 85%-95% and you get to go home immediately after surgery.  Sometimes the sling is combined with other procedures like an endometrial ablation for patients who are having heavy menses too.. If you are going to have an endometrial ablation or even a hysterectomy and you also have urinary incontinence make sure you  talk to your healthcare provider about doing a bladder sling surgery at the same time. 

Remember if you have urinary incontinence it is very common and not something you have to put up with. So call Creekside OB/GYN of Folsom at (916)984-7428 and schedule your appointment today.