By Dr. Bradley E. Jacobs
From scouting out every restroom in the workplace, to going dozens of times a day, to forgoing outings to the movies, people with untreated urinary incontinence live in constant fear of having an embarrassing accident. Urinary incontinence is a common problem affecting an estimated 18 million women in the U.S., yet according to the National Association for Continence, women wait an average of six years from the first time they experience symptoms to visit their physician for a diagnosis.
People think it’s a normal process of aging or childbirth, but it’s really important to distinguish that although urinary incontinence is common, it’s not normal. It is a legitimate medical condition and it’s treatable. Here are some tips to keep in mind…
Know Your Type
Physicians say it’s important to talk about any urine leakage issues you have with your ob/gyn, primary care doctor or urologist in order to get a diagnosis of the type of urinary incontinence you may have.
The most common is stress urinary incontinence, a movement-type incontinence that happens when the person laughs, coughs, sneezes, jumps or runs.
The second most common type is urge incontinence or overactive bladder syndrome. This leaking is because the bladder spasms or squeezes down involuntarily without notice. Generally the leaking is preceded by a strong urge to go to the bathroom and that’s where the name comes from.
It’s important that people understand what type of incontinence they have so it can be treated properly. The advertisements you see for the ‘gotta go’ prescription medications are designed to treat urge incontinence by preventing bladder spasms, but it will not do anything for women with stress incontinence.
The Surgery Myth
Many patients that I see believe that surgery is the only option and that the procedure will work for only a short period of time. For women with stress incontinence, the most common surgical option is called the sling procedure, an outpatient procedure that takes less than 30 minutes.
This type of surgery has really advanced in the past ten years or so. Through the years there have been many procedures that have attempted to help with this problem and only a few have stood the test of time. The sling procedure has become the current gold standard procedure.
Researchers have been tracking the success rate of the sling procedure for well over ten years and have found the success rates in the 80 to 90 percent range.
We want people to realize that not all urinary incontinence types are treated the same way with surgery. In fact, urge incontinence is not helped at all with surgery, and can actually make it worse. Oftentimes, we recommend other non-surgical treatment options.
For many patients, strengthening the pelvic floor, the muscles that support the bladder, are an important step. Doing Kegel exercises at home can help some but you really want to find a formal Pelvic Floor physical therapy program for strengthening the muscles. I recommend checking with your local hospital or ob/gyn, urology or physical therapy practice to see if they offer a pelvic floor strengthening program.
Doctors also advise people with urinary incontinence to avoid caffeine and alcohol, which act as natural diuretics. The lining of the bladder is particularly sensitive to caffeine and alcohol. Because they make you go more frequently, we highly encourage patients to restrict their use, especially in the evening before bedtime.
Dr. Bradley E. Jacobs is a physician at Lyndhurst Gynecologic Associates in Winston-Salem and is the Medical Director of the Program for Continence and Pelvic Floor Disorders at the Maya Angelou Center for Women’s Health and Wellness at Forsyth Medical Center. He has been treating women with urinary incontinence for more than 10 years and has seen first-hand the struggle his patients go through before seeking help.