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.