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.