Taking Control of a Leaky Bladder
Courtney Carter
/ Categories: WELLNESS, 2024

Taking Control of a Leaky Bladder

Stress urinary incontinence (SUI), or the leakage of urine from the bladder, is a very common and frequently underreported problem affecting mostly women. It’s estimated that 38-55% of all women experience SUI at some point in their lives.

Caused by a weakening of the muscles in the pelvic floor, which prevent the bladder from holding in urinary whenever pressure is increased on the organ, the chances of experiencing SUI increases as person ages. Regardless of age, a person with SUI may may experience leakage when they:   

  • laugh

  • cough

  • sneeze

  • exercise

  • lift a heavy object

  • stand from a seated position

While anyone can develop SUI, there are factors that put you at greater risk. These include:

  • childbirth, especially vaginal birth

  • obesity

  • menopause

  • diabetes

  • uterine prolapse

  • surgery for prostate cancer or enlargement

  • pelvic surgery, including hysterectomy


Even though SUI is very common, it is not a normal part of aging and, more importantly, it can get better with appropriate treatment.

 Depending upon the severity of SUI, treatments can range from lifestyle changes to surgical. Common first-line treatments includes:

Weight loss: Studies have found that individuals with obesity who lose 5-10% of their body weight can achieve a 70% reduction in SUI symptoms

Pelvic floor exercises: Often referred to as Kegels, pelvic floor exercises strengthen the muscles that support your bladder and urinary system, and can significantly reduce—and in some cases—or eliminate symptoms of SUI.

Managing fluid intake and bathroom breaks: Keeping fluid intake at or under 64 ounces  per day—provided you’re not exercising or feeling thirsty—and taking regular bathroom breaks—every two hours—can help reduce symptoms of SUI.

Dietary changes: Certain foods and fluids are known to stimulate the bladder and may contribute to SUI. The following foods and drinks should be avoided:

  • caffeinate, this includes drinks like coffee, tea, energy drinks, and some 

  • acidic juices, especially orange, grapefruit, and tomato 

  • alcohol in any form

  • carbonated beverages, sodas, or seltzers, especially those with artificial sweeteners 

Prosthetic device: Commonly made of a soft silicone, a pessary is a device that fits the vagina to support the bladder. Patients must be fitted for a pessary. A properly fitted device can be worn for days or even months.

If those measures don’t work, surgical options may be considered.

Common SUI-corrective procedures include a midurethral sling and urethral bulking options are both highly effective, minimally invasive, and can be performed without an overnight stay at the hospital.

Living with stress incontinence can be challenging. However, you don’t need to suffer in silence or embarrassment. If you’re experience symptoms of SUI, schedule an appointment with a urologist to discuss how you can regain control of your bladder and your life.

 

Anthony Donaldson, MD, is a board-certified urologist at Southwestern Vermont Medical Center

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Six Questions with the Medical Director of SVMC Orthopedics

Dr. Michaela Schneiderbauer, medical director of orthopedics and orthopedic surgeon, answers six questions about getting orthopedic care right now.

1. What types of patients are you able to treat right now?

We are happy to see patients with all sorts of conditions returning to the practice for care. Patients have heard that the Governor has lifted restrictions for elective procedures, and they are ready to investigate their options for joint pain relief. Plus, the weather is getting nice again, so people are active outside. We've seen an increase in injuries related to outdoor activity, too.


2. Are you seeing patients remotely via telemedicine?

Yes. We offer telemedicine, and we use it a lot. Of course, there are limitations for those that need an X-ray or a physical exam. But telemedicine is a great option for initial visits when we need to collect patients' health history and for follow-ups.


3. How has care in the office changed over the past several months?

Patients will notice that we have gone beyond all of the Centers for Disease Control and Vermont Department of Health recommendations for office visits. All of our staff are wearing masks and shields or goggles, and patients are expected to wear a cloth face covering when they come in. In addition, we are making efforts to limit the number of people in our waiting rooms and office at any one time. For example, part of the check-in process now happens on the phone, instead of in person.


4. How is preparing for a surgery and recovering from a surgery different since COVID-19 became a concern?

Like for office visits, our pre-surgery processes have all been ramped up well beyond the state and national recommendations designed to decrease risk of contracting COVID-19. A few days before the surgery, we test patients for COVID-19 and ask them to self-quarantine until their procedure. The patient arrives to the hospital in their own cloth face covering. Visitors are limited. After the procedure, we provide patients with an app that allows them to note their temperature and any type of respiratory symptoms for a few weeks. If any of the information falls outside the norm, a nurse gives the patient a call. These are all examples of ways we are going beyond our very high infection-prevention standards to ensure safety for patients, their families, and our staff.


5. What would you like to share with people who postponed a joint replacement or other orthopedic care because of COVID-19?

Here in Vermont cases of COVID-19 cases have been relatively low. The Governor has given his approval by lifting restrictions for elective procedures, even those requiring an overnight hospital stay. SVMC started with an exceptionally low rate of hospital-acquired infections and added many extra precautions on top of that. We have the attitude that it is definitely safe to resume care both surgeries and other types of orthopedic care.


6. What are the greatest risks and rewards related to having orthopedic care now?

From our position as one of the safest hospitals in one of the safest states, the risks of contracting COVID-19 and other illnesses during a procedure or other care are very low. Many patients know this. They are coming in for their procedures and joint replacements. Many of them will recover and be active again in time to really enjoy this summer. That’s our goal: to help every patient resolve their orthopedic issues so that they can get back to doing the things they love.

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