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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Resuming Regular Care

So many important medical appointments were booked for March and April and canceled during the height of the pandemic. Now we are beginning to refocus on the fact that skipping appointments, even if you are feeling well now, could become harmful.

One important group of patients that we are eager to see are those with serious chronic conditions. These diseases require patients to see their primary care provider or a specialist at least once a year and sometimes far more frequently than that. Those with heart failure, kidney disease, diabetes, high blood pressure, and chronic obstructive pulmonary disease, for instance, all require regular contact with your provider.

Another group of patients we'd like to see are those with new medical concerns. We know that new medical concerns don't stop during a pandemic. Some conditions, like depression and anxiety, are far more prevalent during a pandemic than before. In many cases, new conditions are easiest to treat when patients first notice symptoms, and delaying care for these conditions can be dangerous.

Even regular care for those who are healthy is as important as ever. Other diseases—cancer in particular—haven't gone away. So, if you would normally be getting a screening such as a colonoscopy or mammogram, it's time to schedule an appointment. Many cancers can be detected and treated early with better outcomes. We can only expect those good results, if people are screened.

For children, regular vaccines are very important. If a big portion of the population neglects to get important childhood vaccines on schedule, we may be susceptible to outbreaks of measles or whooping cough.

There are many steps we have taken to improve safety for those seeking medical care. The first one is the availability of telemedicine. If the condition you are seeking treatment for does not require diagnostics or a physical exam, your provider can meet you virtually using any Internet-enabled device or over the phone. See details here.

If you do need to come to the office, you will notice check-ins at entrances, where staff check patients and visitors for respiratory symptoms and ensure that all are masked. You'll also notice efforts to space the waiting rooms to improve social distancing.

So how do you get the care you need?

  • If you have a primary care provider, call in to see what you may have missed during the pandemic. Did you miss an appointment to manage a chronic condition? Also share any new health concerns you have and check that you and your family members are up to date on all of your screenings and vaccinations.
  • If you don’t have a regular doctor, it makes sense to get one now. Locally, call the find-a-provider line at 802-447-5007 for a directory of practices that are accepting new patients.
  • Those with time-sensitive medical needs can use ExpressCare, a walk-in clinic, on the hospital campus in Bennington. Be sure to call ahead to 802-440-4077 if you have respiratory symptoms.
  • For Emergency Care, always come directly to the SVMC Emergency Department.

Most off all, we want our patients to know that we are here for them. There is no longer a need to delay medical care, whether for known conditions, new concerns, or preventive care. In every step we take, we are protecting patients against COVID-19 and helping patients with all of their other medical needs, too.

Bob Schwartz, MD, is associate medical director of Dartmouth- Hitchcock Putnam Physicians at Southwestern Vermont Medical Center in Bennington and a family medicine physician at SVMC Northshire Campus in Manchester.

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