August 13, 2013
Ok ladies, here's the straight scoop on that embarassing little bit of dribble you may experience when you cough, sneeze, jump, yell or simply don't make it to the bathroom quick enough. Ugh, embarrassing, right???
The medical term for this irritating, unintentional gush of pee is "incontinence". If you leak, know that you are not alone! Mothers, sisters, daughters, BFFs across the world are secretly leaking as you read this! So, it is a common unpleasantry and it is more likely to occur in women who have experienced one or more vaginal births. Or ladies who struggle with their weight, who smoke (damn smokers cough) or who have low estrogen levels (yes, the dreaded menopause).
There are several types of incontinence. A common one is "stress incontinence". So, imagine this: your bladder as a water balloon sitting deep in your pelvis surrounded by a landscape of other organs (uterus, ovaries, bowel) as well as the weight of your abdominal wall. Anything that increases pressure on your bladder or physically stresses it may cause your bladder to try to empty. If you have an awesome bladder, there is a kink in the exit tunnel (your urethra) which prevents this undesired egress. Perfect! But if you have an average bladder, as many of us do, there is no kink or blockade to the outside world due to damaged, tired pelvic floor muscles. So when physical stress or pressure squeezes your bladder, you lose bladder control and leak. Yuk!
Ok, so let's discuss the fix. A variety of treatment options are available. First, try kegel exercises to strengthen your pelvic floor muscles and get some kink back in your urethra. One easy way to learn kegels is to practice stopping the flow when you are peeing. Try it now!!!! Congratulations , you just did a kegel! If you do several sets of these exercises daily, you will likely notice an improvement in your leaking. If this is a challenging skill for you to master, consider working with a physical therapist for your vagina. Yes, they do exist and they are super cool!
If Kegels or pelvic floor physical therapy is not your cup of pee, check out a pessary! A pessary is a small rubber device that comes in many different shapes and sizes. It fits in your vagina and supports the base of your bladder, preventing leakage of urine due to physical stress. This device may be used in certain situations when you frequently leak such as exercise or a pessary may remain in for months at a time in order to continuously treat your leaking. The pessary is not for everyone though....
An alternative to the pessary is surgery. If you are looking for low maintenance, long term treatment for your leaking, consider having an outpatient surgical procedure performed that places "a sling" under your urethra to prevent that urine from going AWOL. While this approach is a fabulous fix if your leaking is so bothersome it is affecting your quality of life, it is associated with some risk . It is worth a detailed discussion with a physician that specializes in bladder dysfunction ( typically a gynecologist, a urologist or a uro-gynecologist) to get the scoop.
Remember, this article is a poor substitute for an evaluation and consultation with a doctor that knows their stuff. Don't procrastinate!!!!
Coming soon- leaky ladies Part II.... A discussion on the overactive bladder.