Do you leak urine while you Laugh, Cough or
For millions of women around the world, sneezing, coughing and laughing is often accompanied by involuntary leakage of urine otherwise known as stress urinary incontinence.
Stress Urinary incontinence (SUI) is commonly associated with the aging process but can also affect women of all ages. In India, incontinence affects 20% of women aged 30 years and above. For such women, the constant wetness and foul smell of urine is very embarrassing and uncomfortable. Wearing absorbent pads and dressing mostly saris only hide the problem, they do not treat it effectively. However, with proper medical care treatment, these women can regain their quality of life.
If you think you may have urinary incontinence, it's important to know that you don't have to live with it. Today, there are many treatment options that can help you gain control over this condition and improve the quality of life.
Stress Urinary incontinence (SUI) is the unintentional release of urine during normal everyday activities. If you have SUI, you may leak urine when you
Laugh, sneeze, or cough
Walk, exercise or bend
Get up from a seated or lying position
You may also go to the bathroom frequently throughout the day in order to avoid accidents. Stree incontinence can affect women of any age, and is more often caused by weakness in the pelvic floor which results from menopause, pelvic surgery, or multiple childbirths.
Causes of incontinence
There are two basic causes for SUI:
(a) Weakening in the pelvic floor
The muscles of the pelvic floor support the organs of the lower urinary tract, including the urethra (tube through which urine come out of bladder). A strong pelvic floor keeps the urethra in position until it is time to urinate. A weakened pelvic floor cannot hold the urethra in its correct position, so an increase in intra-abdominal pressure say from a sneeze or a cough would cause a descent of the urethra, resulting in a leakage or urine.
(b) Intrinsic sphincter deficiency (ISD)
The sphincter muscles hold the urethra closed until it is time to urinate, when they relax their grip and allow urine to flow. Women with ISD have sphincter musles that do not function as they should, which can cause urine to leak during movements that put pressure on the bladder.
Treatments for Incontinence
Many cases of female urinary incontinence particularly SUI, are treatable and even curable. Treatment options for SUI includes:
1. Behavioural / Muscle Therapy
Behavioural / Muscle Therapy teaches sufferers new ays to control their bladders and the muscles involved in urination. The first line of thereapy is usually Kegel exercises, which are used to strengthen the pelvic muscles.
Medication can inrease or decrease the activity of the bladder muscle, or increase or relax the closure of the bladder sphincter. It is the mainstay treatment for urge incontinence. However, SUI does not commonly respond to drug therapy. Only in some cases where SUI is associated with estrogen deficiency, it may be treated with hormone replacement therapy such as vaginal cream or estrogen patches.
In situations where conservative treatment fails, patients will require surgery to manage their SUI. With advancement in technology, surgery has become minimally invasive and requires no hospitalization
FAQ's (Frequently Asked Qustions)
Q: Will I have pain after the procedure?
A: Some mild pain may occur over twenty four to forty eight hours after the surgery. This could be controlled by simple pain relief such as aspirin etc.
Q: Will I have difficulty emptying my bladder?
A: A few patients have temporary difficulty and may require an in-out catheter in the ward.
Q: What is the risk of urinary infection?
A: This may occur in up to 6% of patients and is treated by antibiotics and an adequate fluid intake.
Q: When can I leave the hospital?
A:Usually the same day.
Q: When can I have intercourse?
A: After 4 to 6 weeks.
Q: When can I play sports?
A: Usually after 4-8 weeks to allow the wounds to heal and the mesh to settle into place.
Q: When can I return to my usual routine?
A: Yes after about 2 weeks, but it is wise to avoid unnecessary heavy lifting for 6 weeks.
Q: When can I drive?
A: Usually within 2 weeks.
Q: Does the mesh remain there?
A: Yes, evidence from long term follow-ups show that it is inert and remains there to support the urethra. The presence of the tape will not be noticed and it is safe.
Q: Are there aby side effects from this?
A: Occasionally a portion of the mesh may be exposed but this is uncommon. It is treated by antibiotics, and closure of the wound.
Q: What happens if the mesh falls and I become incontinent again?
A: You would need to be investigated with fresh urodynamic tests and treatment decided on the basis of these. Occasionally a new TVT has to be inserted.