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Don’t Fear the Sneeze: Solutions for Stress Incontinence

Sneezing. Laughing. Lifting. If you worry about urine leakage during one of these events, you may be one of many women suffering from stress incontinence. Urine leakage occurs when there is pressure on the bladder and the pelvic floor muscles cannot hold it in. Although stress incontinence can happen to men or women it is more common in women, especially those who have had a vaginal childbirth.

Non-Surgical Treatment Options

According to Linda Fox, MD, a gynecologist who specializes in female pelvic medicine and reconstructive surgery, strengthening the muscles in the pelvic floor is the first option if you experience stress incontinence.

According to a study in the British Medical Journal, practicing pelvic floor exercises, also known as Kegels, where the pelvic muscles are squeezed and released eight to 12 times, three times a day significantly strengthened the pelvic floor muscles. If you have difficulty with Kegels or don’t see meaningful results, pelvic physical therapy by a trained physical therapist is a hands-on training that can teach you how to exercise those muscles.

“More than 50 percent of women will be helped with pelvic floor exercises or physical therapy,” said Fox. “It works very well but it’s like going to the gym you have to keep doing it to continue seeing results.”

Another non-surgical solution for urinary incontinence is a pessary, which is a device that looks similar to a diaphragm and is inserted into the vagina to help support the bladder. The results are immediate and it works as long as the device is used. The pessary is custom-fitted to your body and available from a physician.

Lifestyle changes can help with stress incontinence. According to a study published in the British Journal of Urology International, obesity and drinking carbonated beverages daily appeared to contribute to the onset of stress incontinence. The American College of Obstetricians and Gynecologists also recommends women limit caffeine and other fluids, and stop smoking to improve symptoms.

Sling Surgery

For women who don’t see good results from the options above, midurethral sling surgery is the most common surgical treatment for stress incontinence. The procedure is conducted as an outpatient procedure, meaning patients don’t need to spend the night in the hospital.

During surgery, a small piece of synthetic mesh about the size of a piece of tape is positioned to support the bladder. The material is placed vaginally and not through an abdominal incision, so recovery is quick. According to Fox you can usually resume most normal activities within a week, but may not do any high impact exercise, heavy lifting or have intercourse for six weeks.

Fox reports that the surgery gives permanent results, although women should wait until they are finished having children to have the procedure.

“Bladder slings have become the gold standard for surgical treatment of stress incontinence,” said Fox. “The procedure has been around for many years, and success is high and complications are low.”

Other types of incontinence such as urge incontinence or overactive bladder are not treated with surgery but can be treated with medication and other options. Talk to a doctor familiar with the different causes of urinary incontinence to help diagnose your condition.

If you are a woman experiencing incontinence that interferes with your life, ask your primary care provider for a referral to a gynecologist specializing in treatment of incontinence to explore your options.