When should I seek care for my incontinence?
A bladder control problem can be more distressing than other medical conditions. It affects the quality of your life, making you feel embarrassed or cut off from friends and activities you used to enjoy. Many sufferers think that they are the only ones with this problem and effective treatments are not available. Nothing could be further from the truth. One out of three women experience urinary incontinence (the accidental loss of urine) at some point in their lives. Incontinence may be the result of pelvic muscles weakened from childbirth and aging or due to other medical conditions such as stroke, diabetes, or bladder infection.
The good news is that bladder control problems can be treated successfully. The time to seek treatment is when your urinary problems are negatively affecting your quality of life, and that is different for each woman. You certainly do not have to “learn to live with it.” Your individual plan will depend on your bladder problems as well as the type of treatment you prefer. Some women choose to have surgery, while others would rather start with conservative therapy.
Will this just go away on its own?
Possibly, however often urinary incontinence becomes more severe as women get older.
A friend told me to do Kegel exercises. Will that help?
Pelvic floor muscle exercises or “Kegel” exercises as they are commonly known, can absolutely help some women regain bladder control. However, many women are unable to correctly squeeze their pelvic floor muscles on their own. The muscle contraction is assessed during our evaluation and pelvic floor physical therapy is sometimes recommended if a patient is unable to adequately contract these muscles on her own.
What kind of surgeries to you offer?
There is an office procedure in which the urethra (the urinary tube) is effectively “tightened” by injecting a bulking agent around the urethra and bladder opening to help prevent the loss of urine. The procedure is performed through an instrument with a small camera and no incision in required.
The mainstay of surgical procedures involves placement of a “sling” under the urethra to help it stay closed during activities that may make you leak such as coughing, laughing, or exercise. Traditionally this procedure was done with abdominal and vaginal incisions using a strip of the patient's own tissue to support the urethra. There are now minimally invasive techniques in which a strip of surgical mesh is placed under the urethra to achieve better support, often referred to as a “TVT” or “TOT”. This technique avoids the abdominal incision. Although both procedures appear to have the same effectiveness, the minimally invasive technique can be done in a shorter amount of time as an outpatient procedure, and typically the recovery time is shortened as well.
Am I too young to be incontinent?
Unfortunately, no. Although the average age of treatment for urinary incontinence is in a woman's early 50s, some patients present as early as in their 20s. Many factors may affect the pelvic floor and bladder including childbirth history, work history, activity level, presence of other medical conditions, and genetic factors which are different for each woman.
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