Fit City: What is the cause of stress urinary incontinence?
Dr. B: If you imagine your bladder is a water balloon. At the opening of the balloon you tie a knot to keep the water inside the balloon. We call this knot the sphincter. Attached to the knot is a straw that drains the balloon when the knot loosens. We call this the urethra. Over time the integrity of the knot can be compromised by injuries leading to a loosened knot. If you now put pressure on the balloon that has a loosened knot, you will start to lose water through the straw. This is exactly what is happening during episodes of stress urinary incontinence.
Fit City: In recent years, women have become the most active group (59%) of runners in sanctioned road races in the United States. One of the more taboo issues many of these women deal with while running is urine leakage. How common is this problem, and who should these women seek out for help with this issue?
Dr. B: We call this condition Stress Urinary Incontinence. You may have Stress Urinary Incontinence if you lose urine during activities such as coughing, laughing, sneezing, and exercise. Physicians who specialize in Urogynecology are experts in the assessment and treatment of women with lower urinary tract issues such as stress urinary incontinence.
Fit City: Are there certain women who are more likely to develop stress urinary incontinence during their lifetime?
Dr. B: Some women carry a genetic predisposition for the development of stress urinary incontinence, but there are other risk factors that can increase the risk of stress urinary incontinence such as a history of pregnancy and childbirth, obesity, chronic cough, chronic heavy lifting, and constipation. The key is anything that causes a woman to bear down repeatedly and at a high pressure can increase the risk of developing stress urinary incontinence.
Fit City: How is stress urinary incontinence diagnosed? What kind of evaluation should I expect when I make an appointment with a doctor to address my concern?
Dr. B: The first step is making an appointment with an Urogynecologist to discuss your unique situation. Your doctor will take a bladder history and assess any risk factors you have for developing stress urinary incontinence. You may be asked to cough during the exam to look for leaking. Your doctor may perform certain tests to ensure your bladder empties correctly and will likely screen you for a urinary tract infection. If there are still questions with regard to your diagnosis, your doctor may order specialized bladder testing to take a closer look at your bladder’s ability to store and empty urine.
Fit City: Once the doctor confirms the diagnosis of stress urinary incontinence, are there any lifestyle adjustments I can make to improve my symptoms?
Dr. B: There are both non-surgical and surgical options for the management of stress urinary incontinence. Non-surgical options include lifestyle changes such as fluid intake manipulation and weight loss. Maintaining a healthy weight has been shown to reduce symptoms of stress urinary incontinence. If you have constipation issues, have your doctor recommend a bowel regimen for you.
Fit City: Aren’t there specific exercises I can do to strengthen my sphincter muscle?
Dr. B: Yes! With the guidance of a pelvic floor physical therapist, you can learn pelvic floor exercises that can decrease your leaking. Up to 75% of women with stress urinary incontinence show an improvement in symptoms with pelvic floor therapy.
Fit City: For those who have failed lifestyle modifications and pelvic floor physical therapy, what surgical options are available for these women?
Dr. B: For stress incontinence, our goal is to correct the support of the urethra. The most frequently performed surgical option is called a sling procedure. The sling provides improved functioning of the urethral sphincter when you cough, sneeze, or exercise. There are other surgical options that are utilized in more complex situations where we use stitches or harvest a graft of your own tissue to rebuild the urethral support. In some patients who are not ideal surgical candidates, we utilize a hypo-allergenic filler material and inject this into the urethra to decrease the caliber of the urethral tube and to promote new collagen formation. These injections can be performed under anesthesia or in an office setting with success rates up to 80%.
Fit City: How can patients reach you to schedule a visit to discuss their bladder concerns?
Dr. B: Patients can be scheduled with me by calling Optimal Health Associates at 405-715-4496 Monday through Friday. Patients can also refer to our website for more information at www.optimalhealthassociates.com. I can be reached on Facebook and Instagram by using @Oklahomaspelvichealthexpert
To all our female athletes, remember just because a medical issue is common does not mean it is normal. Don’t let your bladder dictate your daily activities.
