Written by: Dr. Jonathan Weinstein
There are three types of urinary incontinence with approximately 18 million adults (85% are women) affected in the United States. You are not alone. It usually takes 4-6 years before a patient will see a healthcare professional for this condition.
Overflow incontinence is usually a result of long standing bladder obstruction or nerve damage to the bladder which results in bladder distention and then leakage. Bladder spasms or detrusor instability (DI) is the uncontrolled contraction of the bladder resulting in leakage.
Lastly, stress urinary incontinence (SUI) is the involuntary loss of urine during physical activity, which may include but is not limited to coughing, laughing or lifting. Most commonly, SUI occurs when the muscles that support the urethra (the tube that carries urine out of the body) are weakened or damaged. This can happen as a result of childbirth, trauma, hormone changes and many other reasons. On occasion this type of incontinence can be a result of failure of the valve or closing mechanism that lets you hold your urine until you can get to a restroom.
Usually a thorough history and examination can determine the cause of incontinence both medical and surgical options are available for treatment.
Treatment options range from:
1) Changes in your diet and fitness routine
2) Timed voiding
3) Pelvic Floor Muscle Training (Kegels) exercises – which are well described in the video below
4. If you have finished childbearing, than the gold standard for stress urinary incontinence, is a minimally invasive surgical procedure such as a single site urethral sling. I choose to use the Solyx SIS System because of its ease of placement and limited risk of injuring to any surrounding structures. The entire procedure is done as an outpatient and takes only 30 – 45 minutes to perform. After the procedure most patients can return to office work in just a few days. Moderate activities within 2 to 4 weeks and can resume even strenuous activities at 6 weeks. The most satisfying part of this procedure is that most women see results immediately following the procedure. The video below describes one patient’s experience
Let’s work toward getting rid of those daily pads, running to the nearest bathroom and leaking urine when you have sex. Allow yourself to play with your kids and exercise without having to worry about an accident. Stop getting up three times a night to urinate. There are many options, do not feel embarrassed to speak to your provider about your problems because you are not alone, millions of other women suffer for years before seeking help.