Physician Health Articles
Sutter Davis Hospital

Incontinence – More Common Than You Think
By: Susan Maayah, M.D.

Do you ever find yourself leaking urine when you laugh, cough, sneeze or exercise? It is embarrassing to talk about, but the truth is, this condition is a very common female problem called stress urinary incontinence.

What causes this unpleasant condition? The biology is fairly simple. The urinary tract is made of four main compartments: the kidneys produce urine; the ureters carry urine from kidneys to the bladder, the bladder stores urine and the urethra releases urine outside the body. Stress incontinence is generally caused by a weak urethral muscle. The bladder contraction that occurs when the bladder fills can be stronger than the weakened urethral muscle, so urine leaks out. 

It has been reported that 35 percent of American women over the age of 50 have urinary incontinence. This condition is more prevalent in women. Studies have shown that the urethral muscle is weakened by some kind of damage or injury to the muscle. Usually this damage is caused by trauma from vaginal child delivery, repeated descent of the pelvic floor from chronic coughing, or straining from lifting or constipation.

The good news is there are many things you can do to strengthen this muscle and improve or reduce urinary incontinence symptoms. The most well known remedy is called Kegel exercises. Kegels are done to help strengthen the pelvic floor muscles. Kegels are performed by squeezing the muscles that allow cessation of urination. Holding for 10 seconds and releasing is the recommended exercise.  Doing 10-20 of these three to four times a day can help strengthen pelvic floor muscles.

Certain lifestyle modifications can also help improve incontinence symptoms.  These include losing weight, avoiding constipation and heavy lifting, drinking less caffeine, and smoking cessation.  Other lifestyle modifications like the use of medication or pessaries (devices that a woman places in the vagina), are also sometimes helpful to alleviate some of the symptoms of stress incontinence. 

If this is an ongoing or worsening problem, your gynecologist may recommend a surgical procedure for you called suburethral sling operation. This is a minor outpatient surgery during which a synthetic mesh material is placed vaginally to support the urethra. This can cure the incontinence problem and keep you dry all the time. Most women find recovery from this type of surgery quick and relatively painless.  The main postoperative limitation you will have is a lifting restriction for about 12 weeks. Approximately 10 to 12 percent of women who have this type of surgery can experience recurrence of symptoms and need a repeat surgical intervention.  Because there are other causes of incontinence that will not benefit from surgery, a complete evaluation is required prior to surgical treatment.

The physicians at Sutter West Medical Groups Women’s Health Department all perform consultations and surgical correction for stress urinary incontinence.  To schedule your appointment, please ask your primary care physician for a referral or call at (530) 750-5880.