Dr. Sohail Siddique provides the answer when in comes to urinary incontinence in women. He also shares what causes it, symptoms, risk factors, and treatment.
Q. How prevalent is urinary incontinence?
A. Urinary incontinence or loss of bladder control is an embarrassing medical condition that affects millions of women in the U.S. About half of adult women have urinary leakage at one time or another. Although it is more common in older women, it also can affect younger women.
Many people are embarrassed to discuss their urinary incontinence with their physician, even though it is a common problem. Some avoid social activities because of incontinence or map out bathrooms when away from home. It often exists for years before a woman seeks help from a physician, and by that time it may be more advanced and difficult to control.
Q. What are the most common types?
A. Two of the most common types are stress incontinence and urge incontinence. Stress incontinence occurs when urine leaks as pressure is put on the bladder with coughing, laughing, sneezing and other types of physical activity. Urge incontinence happens when individuals have a sudden need to urinate and aren't able to hold it long enough to get to the restroom in time.
Q. What are the causes?
A. The primary cause of incontinence is age. Weight gain also is a significant cause. Pregnancy is a risk factor for incontinence. It's not necessarily the type of delivery, just pregnancy itself. There is some genetic predisposition as well. The problem also can be brought on by urinary tract infections. Some medications can cause short-term bladder control problems.
Q. What are the symptoms?
A. The symptoms are uncontrolled loss of urine or wetness in the vagina and the perineal skin. Prolonged incontinence may put individuals at risk for getting rashes, sores, and skin infections.
Q. What are the risk factors?
A. Risk factors for incontinence in women include older age, number of pregnancies, especially pregnancy with large birth weight children and large weight gains in pregnancy. Other risk factors are obesity, ethnicity and genetic factors, especially dementia and functional impairments. When people get older, they sometimes can't make it to the restroom as quickly as they did when they were younger.
Q. What are the treatments?
Incontinence is very treatable and should be addressed. We recommend women start with conservative steps such as pelvic exercises (known as Kegel exercises), physical therapy or biofeedback and weight loss. Kegel exercises help strengthen the pelvic floor muscles. Individuals should consult with their physician to learn how to do the exercises correctly, because they are effective only if done properly. Only half of women do them properly.
Lifestyle changes that might help include quitting smoking, avoiding alcohol, caffeine, and other bladder irritants, treating constipation and avoiding lifting heavy objects.
Every treatment plan is geared for the specific type of incontinence that an individual may be experiencing. Some drugs can help the bladder empty more fully during urination, while other drugs tighten muscles and can lessen leakage.
Another type of treatment is a pessary, which is a device placed into the vagina to help prevent leakage. Surgery such as a sling procedure or bladder neck suspension to repair faulty structures is a mainstay of treatment.
Q. Where to go for more information?
A. For more information about urinary incontinence visit these professional organization websites:
American Urological Association
Dr. Sohail Siddique is an assistant professor of obstetrics and gynecology and chief of the urogynecology division of the department at Southern Illinois University School of Medicine. He also is a member of SIU HealthCare, the medical school's practice group.
