My Secret Struggle: Leaking the Truth About Urinary Stress Incontinence

I am only 37 years old, but I suffer from urinary stress incontinence. It is embarrassing to admit, but it has become a big problem for me. There are many things that cause me to "leak": playing with my son, squatting down to pick something up, teaching my son how to jump rope, walking on my treadmill, sneezing, coughing - the list is too long to mention them all. I have tried the recommended pelvic floor exercises and prescriptions from the doctor, but so far, there has been no change.

I originally thought my problem with stress incontinence was because I have Interstitial Cystitis, which is a disease that causes severe inflammation of the bladder. But the Urologist told me that it was a result of a vaginal birth delivery. Stress incontinence is often seen in women who have had vaginal childbirths and women who have had multiple pregnancies. Because of vaginal childbirth, the bladder, urethra, or rectal wall will stick out into the vaginal space causing a pelvic prolapse.

Stress incontinence is the most common type of urinary incontinence in women, with over 50% of all women having occasional urinary incontinence. I would fall in the 10% of all women who have frequent urinary incontinence. If you are over the age of 75 then you are among the 20% of women who experience daily incontinence.

Just by being female, you increase your risk factor for suffering from stress incontinence. Other risk factors include: aging, childbirth, smoking, obesity. Also if you have chronic conditions that result in coughing, such as bronchitis and asthma, you are at increased risk.

I am definitely not alone in my struggle with stress incontinence. Approximately 12,000,000 adults suffer from urinary incontinence. Although it is more common in women over 50 years of age, it also affects younger people, such as myself.

There are different tests that your physician can do in order to find out what the cause of, and if you suffer from, stress incontinence. The first thing my Urologist did was to take a urine culture to rule out any signs of a Urinary Tract Infection (UTI). When those results came back negative, he did a pelvic exam and found that my bladder is starting to bulge into the vaginal area. Some other tests done include:

Post-void residual (PVR) to measure the amount of urine left after urination.
A urinary stress test where you will be asked to stand with a full bladder and cough.
A pad test where a patient is asked to exercise with a pre-weighed sanitary pad on. After exercise, the pad is weighed to determine the amount of urinary loss.
A pelvic or abdominal ultrasound.
X-rays of the bladder and kidneys.
Tests that measure urine pressure and flow.
A Cystoscopy, which is an outpatient procedure, where the bladder is fully inspected.

Your physician may at first just ask you to make some changes in your daily behaviors to see if this will help your stress incontinence. You may be asked to decrease your fluid intake, urinate more frequently, treatments to promote regular bowel movements, or to lose weight.

Pelvic muscle exercises (Kegal exercises) can help to control urine leakage. Kegal exercises may help improve the functioning and strength of the urethral area.

If you have mild to moderate stress incontinence, you may see good results from prescription medications. These prescriptions can help block bladder contractions and help to increase urethral strength. For post-menopausal women, estrogen therapy can be used to improve urinary urgency, frequency, and burning.

There are also surgeries available as an option. Surgeries for stress incontinence include a collagen injection, anterior vaginal repair, needle bladder neck suspension, retropubic suspension and the sling procedure. The sling procedure is usually the first choice recommended by physicians for women. A sling is made by taking a piece of abdominal tissue or synthetic material. This sling will be used to push on the urethral sphincter which will prevent the leakage of urine during stressful moments. The surgeon will have to make a small cut in the abdomen and vagina for this procedure.

Results have shown that 80% - 90% of women who have had the sling procedures for stress incontinence are cured. Of course, no surgery goes without the risk of complications. Some complications for this procedure may include infection, a non-healing vaginal wall, abscess formation, urgency, urge incontinence and urgency retention.

At my next Urologist appointment, I am going to discuss the sling procedure with him. To be able to play with my son without the embarrassment of leaking would be a dream come true!