Posted by Brigham and Women's Hospital January 29, 2013
Dr. Vatche Minassian, Chief of Urogynecology at Brigham and Women’s Hospital, is the guest author of today’s post on stress urinary incontinence, the third post in a series about pelvic floor disorders that impact the quality of life in women.
The other day I saw a young woman who had delivered her first baby a few months ago and was complaining of urine loss with laughing and sneezing. Her condition, a common one, is known as stress urinary incontinence. She was worried that she would need surgery to stop her urine loss since her mother and her grandmother both had surgery for incontinence. Her pelvic exam was normal and she had no obvious reason for her incontinence, other than the fact her pelvic floor muscles had weakened due to her pregnancy and delivery.
I reassured her that surgery was not her only option and that, in her case, I would first recommend strengthening her pelvic floor muscles with exercises and physical therapy. We also discussed weight loss and other conservative measures. By the time she left the office, she was less anxious and was eager to start getting in shape as a way to rehabilitate her pelvic floor muscles.
Many of my patients are surprised to learn that urinary incontinence is a very common condition. More than one in three adult women lose urine, making urinary incontinence more common than conditions like diabetes or heart disease. Urinary incontinence affects women of all ages, and its frequency increases with age. Despite these high numbers, very few women talk about their condition, and even fewer women seek care for incontinence. When women with incontinence are asked why they are not seeking help, they commonly say: “I’m too embarrassed,” “I thought this is part of life or part of the aging process,” “My mother has it and my grandmother had it,” “I did not know treatment is available,” “I do not want to have surgery,” or “I have other more important things that I need to take care of.” It is really unfortunate so many women silently suffer and live with incontinence for so long before seeking care.
Like my patient described above, most women with incontinence have what is known as stress urinary incontinence, reporting urine loss with activities such as coughing, sneezing, laughing, lifting, jumping, and running. Risk factors associated with stress incontinence include giving birth by vaginal delivery, being overweight, smoking, and lifting heavy objects. Many of these risks are modifiable. In other words, by getting in shape, quitting smoking, and avoiding heavy weight lifting, many women can improve their condition. In fact, there is evidence that if an obese or overweight woman is able to lose 10 percent of her weight, there will be a 50 percent or more improvement in her urinary incontinence symptoms. In addition, beginning pelvic floor exercises like Kegels (as early as the first pregnancy) will also treat and prevent stress urinary incontinence in many women.
If lifestyle changes and exercise do not help address stress urinary incontinence, minimally invasive procedures may be considered. These procedures, often performed as day surgery, have high success rates, low complication rates, and allow women to quickly resume normal activities and work.
The bottom line with stress urinary incontinence is that it is very common, early prevention is key, and highly successful treatment is available. If you think you, or someone you know, has it, please speak up, discuss it with your doctor, and do not procrastinate. Help is available.
Learn more about common urogynecologic conditions:
- Brigham and Women’s Urogynecology Group
- Pelvic Organ Prolapse: Common Yet Misunderstood
- Overcoming the Challenges of Living with Interstitial Cystitis
- Overactive Bladder: Tired of the Interruptions?