What is Urinary incontinence Dr. Rubina Shanawaz

Do you involuntarily leek urine when you laugh hard or sneeze? To find a solution to this embarrassing situation, read on

1. Isn't involuntary leakage of urine a part of having children & growing older??

Though it is caused by repeated childbirths, hormonal changes, there is a solution to this embarrassing predicament which more than 1 in 10 women suffer from but silently endure due to the stigma associated with this condition.

2. What is the medical term for this condition?

Involuntary leakage of urine during activities such as coughing, sneezing, lifting weights or laughing is referred to as Stress Urinary Incontinence (SUD) where urinary incontinence refers to inability to control urine & stress refers to its precipitating factor.

3. How common is Urinary incontinence?

Around 1 in 10 women suffer from varying degrees of involuntary leakage of urine. The commonest of these is Stress Urinary Incontinence. Most of the affected women don't realize there are simple, effective treatment options available.

4. What causes such involuntary leakage?

The urinary bladder &urethra the tube which brings urine from the bladder to the exterior) are supported by pelvic floor muscles which contract during coughing, sneezing & exercise to prevent leakage. Weakness in these muscles or damage to the bladder neck support can result in leakage This can be a result of:

• Pregnancy & vaginal birth(as the same group of muscles support the uterus)
• Obesity, Long standing cough/ Constipation
• Lifting heavy weights over a long period of time

These can cause an increase in pressure in your abdomen & aggravate the stress on the pelvic floor leading to involuntary leakage.

• Genetically Inherited factors:
• Women with stress incontinence may also have problems with urinary Urge Incontinence (not able to control urine till reaching the restroom) or incontinence of feces/gas or prolapse (descent of uterus, felt as lump outside vagina). Do not feel embarrassed to mention these problems to your doctor. Pelvic floor problems are more common than depression(1 in 20 women) or hypertension (1 in 3 women)

What are my treatment options? These will depend on the severity of leakage & associated conditions Conservative options include General lifestyle changes:

• Aim to drink 1.5 to 2 liters of water per day to pass urine 4 to 6 times/day
• Maintaining a healthy lifestyle
• High fiber diet to avoid constipation
• Cutting out smoking

Pelvic floor exercises (PFC) The importance of these exercises cannot be over emphasized in mainly preventing and treating mild degrees of urinary incontinence. If practiced regularly and for 3 to 6 months at least, upto 75% of women show an improvement in leakage. It is important for all age groups of women right from first pregnancy and childbirth to post menopause. Surgical Options:- These range from daycare procedures like mid urethral sling suspension (suspending urethra with tape) to laparoscopic/open Burch colposuspension to bulking agents, depending on the individual patients severity of incontinence previous surgeries and other factors. By Dr. Rubina Shanawaz, MBBS, MS(OBG)