Pelvic Health and You

    What Women Should Know About Urinary Incontinence

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    You’ve recently given birth to a beautiful baby boy. You’re overjoyed and filled with a sense that life just couldn’t get any better than this. And then you sneeze.

    For many women, something as simple as a sneeze or cough can result in the embarrassment and frustration of urinary incontinence (UI), which is the involuntary leaking of urine. This problem is particularly common for women during pregnancy and after childbirth. But it also affects women after menopause.

    Let’s take a closer look at UI, including the types, causes, and what you can do about it. But first of all, know that you are not alone. Millions of women suffer from UI, many of them needlessly. Your healthcare provider has a variety of effective treatment options that can put you back in control of your bladder, and your life.

    What are the types of UI? Stress incontinence is leakage of urine that occurs when you cough, sneeze, exercise, or lift something heavy. This can even happen when you laugh. We all know the expression, “I laughed so hard I peed.” Well, it’s true. This is the most common type of UI. With urge incontinence, sometimes called overactive bladder, leakage happens after a sudden, urgent need to urinate. Transient incontinence is a temporary condition due to a medical condition, such as a bladder infection or pregnancy. The leakage stops when the medical issue is treated or
    after childbirth.

    What causes UI? To understand what causes UI, we have to first be familiar with the pelvic floor. The pelvic floor is a group of muscles, ligaments, and nerves that support the bladder, uterus, vagina, and rectum, and help these organs function. During pregnancy, the unborn baby pushes down, and the pressure may weaken the pelvic floor support. During labor and vaginal delivery, the pelvic floor muscles and nerves that control the bladder may be damaged. Women may also experience UI after menopause. When the body stops producing estrogen, the hormonal changes can affect the pelvic floor muscles as well as the lining of the urethra, the tube that empties urine from your body. Urinary incontinence can also be caused by long-term constipation, infection, nerve damage, certain medications, excess weight, soft drinks, and caffeinated and alcoholic beverages. Smoking has also been linked to increased risk for UI.

    How is UI treated? Pelvic floor exercises, called Kegel exercises, can reduce or cure stress incontinence. Bladder retraining, going to the bathroom at set times, or gradually increasing the time between trips to the bathroom can help you regain control of your bladder. Changes in your diet, weight loss, and quitting smoking may also be recommended.

    In some cases, medications may be prescribed to reduce leakage. For example, some medicines help relax the bladder muscles and reduce spasms. One type of device used to treat UI is called a pessary, a small ring that is inserted into the vagina by a doctor or nurse. The ring presses against the wall of the vagina and the urethra, helping to reposition the urethra and reduce leakage. Neuromodulation, or electrical stimulation of the nerves that control the bladder, may help some people with urge incontinence. Biofeedback helps you get in touch with how your body works to improve bladder control. When other treatments are not effective, surgery may be a good option to treat your UI.

    Too many women think that incontinence is a natural result of childbirth or aging, and they just put up with it. Talk to your healthcare provider today. Don’t let the embarrassment of UI keep you from enjoying life to the fullest.

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    Ashley Carroll, MD
    Ashley W. Carroll, MD, is an assistant professor of urogynecology and reconstructive pelvic surgery for VCU Health Women’s Pelvic Health Center.