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BVHS Weekend Column: Female Urinary Incontinence

Do you leak urine when you laugh, cough or sneeze? Do you have an uncontrollable urge to void and leak urine on the way to the restroom? These are symptoms of urinary incontinence that many women experience. Even though some women may believe these symptoms are a normal part of aging, the reality is, symptoms can be treated.

Urinary incontinence can impact an individual’s quality of life. It can be associated with depression and anxiety, work impairment and social isolation. Risk factors for urinary incontinence include age, obesity, parity with vaginal delivery and smoking. Urinary incontinence increases with age, however women in their younger years can also experience symptoms. Thirty eight percent of women over the age of 60 experience incontinence symptoms. Women who are overweight have a nearly threefold increased risk of urinary incontinence. Women who have had vaginal births are at increased risk for urinary incontinence and pelvic organ prolapse. Smoking is also a risk factor for incontinence, as it causes increased coughing, bladder irritation and increased risk for bladder cancer.

Urinary incontinence is the involuntary leakage of urine. It can be provoked by increased abdominal pressure; coughing, sneezing, laughing, which is called stress incontinence, or it can be caused by a functional issue of the bladder resulting in over-activity of the bladder leading to urge incontinence. Some women may experience both. It is a common issue among women that is undertreated. Nearly 50 percent of adult women experience urinary incontinence and less than half of symptomatic women seek care. Many women are reluctant to seek care due to embarrassment and/or lack of knowledge about treatment options.

Treatment options differ depending on the type of incontinence a woman is experiencing. Treatment options include pelvic floor therapy, lifestyle modifications, medical devices, medications or surgery.

Pelvic floor therapy aides in strengthening pelvic floor muscles to provide a backboard for the urethra to compress on and to reflexively inhibit involuntary bladder contractions, preventing urine leakage. Physical therapists that have special training in pelvic floor therapy can assist in treatment for those women suffering from stress incontinence.

Lifestyle modifications include avoiding alcoholic or caffeinated beverages, weight loss (if overweight) and smoking cessation.

In cases with women who have pelvic organ prolapse, surgery may be necessary in order to improve symptoms. The Burch procedure is a mesh free technique that is done robotically. It returns support to the urethral vesical angle (bladder neck) which in turn prevents the involuntary leakage of urine. Complication rates are very low and recovery is relatively easy due to the robotic approach.

If you are experiencing urinary incontinence, whether it be stress related or urge related, there are treatment options that can aid in symptom improvement, leading to improvements in your quality of life.

(Erica Hermiller, APRN-CNP; Blanchard Valley Obstetrics & Gynecology )

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