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Treat that Leak

Eliminating Urinary Stress Incontinence

Do you automatically cross your legs when you feel a cough or sneeze coming on? Do you pass when your friends suggest an aerobics class at the gym? Is jumping on the trampoline with your kids completely out of the question? If you answered “yes,” then you have experienced the frustration of stress urinary incontinence. For too long, women have been told that incontinence was just an unfortunate part of aging. In fact, nothing could be further from the truth. Today there are effective, minimally invasive ways to treat urinary leakage so that you can get back to doing the activities you love.

Stress incontinence – leakage with exertion, such as coughing, sneezing or exercising – occurs when the support around the bladder and urethra (the tube that carries urine from the bladder) weakens. There are many factors contributing to this, including pregnancy, childbirth, and general aging of the pelvic floor.

There are a number of non-invasive treatment options, such as pelvic exercises, that women experiencing stress incontinence should try f rst. However, for some individuals, non-invasive therapies may not be enough. These individuals may be good candidates for minimally invasive surgeries that can be performed in minutes. Over the last few years, technology has improved immensely and excellent options exist.

The most common surgical procedure to remedy stress incontinence involves placing a synthetic sling under the urethra. The sling functions as a backboard to support the urethra. Synthetic sling procedures are considered minimally invasive because very tiny incisions are used. These procedures are done as an outpatient, and patients can drive and do most any normal activity the next day. If their job does not involve lifting more than 10 ten pounds, they can return to work almost immediately. The slings are approved for use by the FDA and are completely safe and effective.

Urge incontinence – accidentally wetting Yourself due to not getting to a bathroom in time – together with the symptoms of frequent urination (using the restroom more than eight times in 24 hours) and urgency (that feeling of “gotta go, gotta go, gotta go”) describe overactive bladder.

There are a variety of treatment options for patients who suffer from overactive bladder including exercises, diet, and lifestyle modif cations, medications, in-off ce procedures, and the newest option: Botox injections.

Botox works by reducing bladder contractions and possibly by decreasing the nerve signals that travel from the bladder to the brain, telling the brain that the bladder is full. The result is a decrease in the frequency of urination, and an elimination or reduction in leakage episodes. Many patients note improvement in their symptoms as soon as a few days after the Botox injection. The improvement is often very dramatic and most patients are pleased with the result. The effect does wear off over time, but most patients do very well after the injection for six to 18 eighteen months. At that point, if desired, Botox may be injected again.

The options above are just a few of the new treatments for incontinence and they represent the variety of solutions available. Just like any medical condition, it’s important to make an appointment with your healthcare provider so that together, you can determine the best course of treatment based on your individual health and medical history.

Lonny Green, MD, is a urologist who specializes in female urology. He is the founder and director of the Virginia Women's Continence Center. Dr. Green and his wife have six children - three boys and three girls.
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