Stress incontinence ranks as the most common form of urinary leakage among women — about one in four women experience the problem in their lifetime. McLeod OB/GYN Marla Hardenbergh, MD, describes the cause and some treatments for this common problem.

Here’s a summary of Dr. Hardenbergh’s comments:

There are different types of urinary incontinence that women can have.

The stress type of incontinence – which is when you lose urine with cough, sneeze or baring down – is one type.

How can you prevent it? There are some things that can help to decrease the symptoms or the progression. Frequently baring down, where you have to grunt such as heaving lifting or chronic coughing can worsen the problem. Some women may benefit from losing some weight to lessen some of the symptoms.

There is a tough layer around the vagina that helps to hold things in place. On top is the bladder and on the bottom is the rectum. A weak place in either the top or bottom can cause the tube from the bladder to the outside (urethra) to drop as well as a hernia.
There are some noninvasive treatments designed to help decrease the symptoms; for instance, physical therapy. I refer patients to McLeod Regional Medical Center in Florence to a physical therapist who specializes in pelvic floor rehabilitation, and a significant number of them report good results.

If that’s ineffective, there is a surgical procedure we’ve performed that helps to put the urethra back up to the correct angle of the bladder. This improves the type of incontinence that happens when you bear down.

The other type is caused by the bladder, a muscle called the detrusor. This muscle contracting causes the incontinence, where the woman feels like she has to urinate right now. If she doesn’t get to the bathroom, it just comes out. Often, this type is treated effectively with some medication. There is a noninvasive work-up that can be performed to determine what’s most at play because patients can have both types of this stress incontinence. The good news is that with treatment, the symptoms can be treated and the patient’s quality of life isn’t affected.

You may also find these articles helpful:

Fixing Incontinence Often Starts with a Bladder Diary

Weight Loss Helps Reduce Your Incontinence

Treating Urge Incontinence

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