More than 25 million Americans live with an uncomfortable condition known as urinary incontinence, or loss of bladder control. Urinary incontinence symptoms range in severity. Stress urinary incontinence is the occasional small leakage of urine while laughing, coughing or sneezing. Urge incontinence is a sudden and nearly uncontrollable need to urinate immediately.
Often, people with incontinence are embarrassed to talk about their symptoms or seek help. However, both stress and urge incontinence are common problems, and there are numerous successful treatments available.
Men may experience incontinence as a result of an enlarged prostate, aging or other causes, but 75 to 80 percent of those affected are women. For most women, a combination of several factors leads to bladder issues. The top risk factors include excessive weight gain, increasing number of pregnancies, the manner in which the baby was delivered, family history, advancing age and, lastly, ethnicity.
Treatment for bladder issues depends on individual health and severity of symptoms. Most bladder conditions can be handled by primary care physicians, general gynecologists or urologists. More complex and severe issues may be referred to a urogynecologist. These are specialists who have undergone additional years of training
“Asking our patients about urinary leakage is an important part of overcoming the embarrassment that women feel about discussing these issues,” says Varuna Raizada, MD, a urogynecologist with Scripps Clinic La Jolla and Rancho Bernardo. “Our first step is to have an in-depth conversation about the condition and how it affects the patient’s quality of life, and then perform a thorough exam. Sometimes simple office-based testing may be recommended.”
With many patients, Dr. Raizada recommends starting with exercises they can do themselves to strengthen the pelvic floor muscles. Kegel exercises, for example, involve repeatedly contracting and relaxing the muscles that help support the pelvic floor. Physical therapy may help as well. A physical therapist trained in pelvic floor rehabilitation may use various therapies, including targeted exercises and biofeedback, to restore the pelvic floor muscles to their proper function.
If these treatments aren’t successful, medications and surgical procedures can help. It’s important to work with a knowledgeable physician who can determine the best treatment for you.