Have you ever passed urine involuntarily when coughing or laughing? That’s what doctors call stress incontinence. It’s a very common condition that can cause those affected a lot of embarrassment. The good news is that there are many simple measures that you can implement to help reduce such occurrences, and if these fail, more advanced medical and surgical treatments can be offered by your physician.
Why does stress incontinence happen?
The bladder is normally closed by a muscular tube called the urethral sphincter, which presses and closes against the pelvic floor muscles. When the sphincter or the floor muscles are damaged, this could lead to incomplete closure of the sphincter, and leakage of urine when the pressure in the bladder increases, such as when we laugh, sneeze, cough, or do sports.
Patients should visit a urologist to asses the type of incontinence and investigate any underlying causes. In men, for example, incontinence can herald prostate problems. So, the first thing to do is to confirm that there are no serious underlying medical problems causing the incontinence.
What can you do to manage stress incontinence?
Once the diagnosis is confirmed, your doctor may suggest several conservative treatments to help alleviate the symptoms or reduce their impact on your life. This is called behavioral therapy, and it can be effective if your condition is not severe:
- Pelvic floor muscle training. Pelvic floor muscles play an integral role in maintaining continence. If these muscles are weak, the urethra cannot close well (imagine trying to step on a hose on the sand to close it). Pelvic floor muscle training, also known as Kegel excercises, might be helpful in strengthening your pelvic floor muscles and improving continence if done correctly. However, some people don’t start seeing results before three months of consistent, daily, training. You know what that means — keep at it, and be patient.
- Daily fluid intake. Six to eight cups of water daily are usually the healthy, recommended amount. Your physician might suggest that you limit yourself to this amount of water, or even less, to reduce the stress put on your bladder. In case you’re wetting yourself during the night, it would be also wise to cut down on fluids a few hours before bedtime.
- Diet. Reduce the amount of caffeine in your diet, a chemical well-known to increase the amount of urine produced by the body. Try to avoid spicy and acidic food, which can irritate the bladder and worsen the incontinence.
- Lifestyle changes. Since obesity is one of the causes of incontinence, exercising and losing weight might be the way to go. You might want to also consider quitting smoking.
- Treat constipation. Add more fibers to your meals and improve your water intake, as constipation can add to the strain on your bladder and worsen the symptoms.
- Bladder training. Your doctor might recommend that you follow a schedule to urinate more often at specific intervals and gradually increase the time between each void, reducing the burden of incontinence.
- Incontinence products. These products are not a treatment for incontinence, however, they may well significantly improve the quality of your life and prevent social embarrassment. Using absorbent pads is a simple option to prevent wetting your underwear in public or during the night.
What if all these measures fail?
Several other, more advanced treatments are available to treat stress incontinence. For women, the doctor might suggest the use of vaginal pessaries, ring-shaped devices inserted inside the vagina to support the urethra and help it close properly.
Your doctor can prescribe drugs at any point during therapy to help control your symptoms and reduce incontinence. These drugs, in combination with behavioral therapy, are very efficient in treating incontinence. They usually work on either improving the muscle tone of the urethra or reducing the contraction of the bladder to help hold the urine in.
If all fails, the doctor might discuss the surgical options with you. The sling procedure is a relatively simple procedure is done in both men and women and has been reported to provide great outcomes in both sexes. In this procedure, the surgeon enters through the vagina or a small skin incision and inserts a sling around the urethra, supporting it, and helping it to close more competently. Other surgical options include the injection of bulking agents, colposuspension, or installing an artificial urinary sphincter.
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