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 General Surgeon Gina Diaz, MD

Both outpatient surgical procedures and those requiring an overnight stay are once again being offered at SVMC. General Surgeon Gina Diaz, MD, answers six questions about resuming surgical procedures safely.

1. How does it feel to be able to, once again, offer all of the procedures you had in the past?

As a surgeon, I like to do surgeries. So, to be honest, it feels wonderful get back to the work I enjoy. From late March through the beginning of May, we were still performing emergency surgeries, so everyone who needed a surgery was able to receive one during that time. But it's good to be back to a mix of scheduled and emergency procedures.

 

2. What types of procedures you perform?

My mentor during training sub-specialized in colon and rectal surgeries, and he passed that expertise and interest on to me. But I decided not to sub-specialize, because I also enjoy doing gall bladders, ulcer surgery, hernias, and the removal of skin lesions, cysts, and melanomas. Dr. Charles Salem and I work as a team on breast cancer surgeries. As a group, we provide thyroid and parathyroid and endocrine surgeries. And I provide colonoscopies. I grew up playing video games, which have a lot in common with colonoscopies, I think.

 

3. What do you like most about your job?

Surgery allows you to fix a problem for a patient right then and there. You don't have to wait 6 months for the problem to get better. You can make a problem go away. It’s very rewarding in that way.

 

4. In general, what additional precautions have been put in place to ensure that care is safe?

As surgeons, our precautionary measures have always been among the most advanced. We have always washed and sanitized many, many times a day. We were accustomed to wearing masks and shields, long before COVID-19. We implemented all of the recommendations from our industry, state, and national health institutions and review them consistently.

The whole team takes and reports their temperature daily. If patients are at risk of COVID-19, we wear N95 masks and can convert the operating room into a negative-pressure room. All of these precautions ensure that we don’t transmit infections to patients and they don't transmit them to us. I feel really good about the precautions that we have put in place.

 

5. What would you like to share with people who postponed care because of COVID-19?

I would share that it is safe to come to the hospital, see your providers, and have surgeries done. Adequate precautions are in place, and they are not going anywhere. We, as a group, feel it's safe. We encourage patients who are apprehensive to ask a lot of questions. We want them to be as comfortable as we are about having their procedure done.

 

6. How do you feel about providing care during this time?

I feel comfortable and safe providing care at this time. The new precautions we have put in place really protect both patients and staff, and the quality of care we provide is as high as ever. 

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