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Forms and Instructions
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Do you leak urine when you cough, laugh, sneeze, or exercise? Do you often have a sudden urge to urinate and must drop what you are doing to rush to the bathroom? If so, you are one of millions of women who have urinary incontinence. This is the involuntary loss of urine, which affects both young and old. Many women feel it is an inevitable consequence of aging or childbirth and their only option is to discontinue their active lifestyle and wear a daily pad. However, many relatively simple treatments are available which can greatly improve a woman’s quality of life and let her return to her normal activities.
There are two general types of urine loss, stress incontinence and overactive bladder. Stress incontinence occurs when pressure is applied to the bladder forcing small amounts of urine out each time. This often can occur with coughing, laughing, sneezing, jumping, exercise, lifting, and even just getting out of a chair. The pressure applied to the bladder is sufficient to overpower the mechanisms that keep the urine within the bladder, and a small amount will escape each time. Risk factors for this include childbirth, chronic cough, excessive weight, smoking and chronic constipation to mention a few.
For some women, pelvic strengthening exercises can help improve the muscles that prevent urine leakage. However, this alone may not be enough for most women. In which case, a simple ?15-minute outpatient procedure can be performed to eliminate stress incontinence. A physician makes a small incision in the vagina and places a ribbon-like synthetic sling under the urethra to provide support. This helps the urethra remain closed under stress, preventing the loss of urine. The sling works immediately and the women can return to normal activities the following day and exercise within about a week.
The second types of incontinence are commonly known as overactive bladder or urge incontinence. This is the sudden intense urge to urinate where a woman may need to rush to the bathroom and may leak on the way. These women may voluntarily urinate frequently so as not to let the bladder ever fill much. They know where every bathroom is located at the mall and may restrict their social activities for fear they will have an embarrassing episode. In normal circumstances, a woman should be able to hold her urine until she makes it to the bathroom. When she is ready, the bladder will contract and empty.
With overactive bladder, the bladder begins contracting involuntarily, the women cannot overcome the bladder’s contraction and she must rush to the bathroom before she has an accident. Caffeine, diet sodas, bladder irritants, low grade bladder infections, neurologic diseases, and excessive fluid intake can contribute to this. Reducing caffeine intake to one or fewer cups per day, limiting fluid intake to only drinking when thirsty, and altering timing of any diuretic medication can greatly improve symptoms. When control is still inadequate a doctor can prescribe a daily medication that helps to relax the bladder and greatly reduce the frequency of urgency.
Although there are two broad types of urinary incontinence many women can have varying amounts of both types. Although this can be quite embarrassing and can force women to change their activities, it is often a very treatable condition. Don’t let urinary incontinence control your active life, seek treatment now.
Dr. Brian Nelson is a board certified ob-gyn at the Longmont Clinic and can be reached at ?720-494-3130.
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