Women’s health: Dealing with stress incontinence

There must be some people out there who still watch Keeping Up with the Kardashians. I’m not usually one of them, but on one of the never-ending Sunday marathons I caught a glimpse of a pretty funny and smart episode where an ordinarily-embarrassing medical problem became a hot topic.

Kris Jenner, the matriarch/momager of the KK brood, came out of the stress incontinence  After her family relentlessly taunted her about her constant need to run to the bathroom, Kris approached Poise pads to be the new face of women who are dealing with this embarrassing issue.  It wasn’t like her privacy hadn’t already been invaded by the  cameramen who practically live with her family!  And it was quite an intelligent money-making venture. 

But what she accomplished was bringing a youthful celebrity face to a very common medical complaint. Many women, some much younger than Kris Jenner, especially after pregnancy, experience urine leaking when there is an increase in intra-abdominal pressure such as when your are laughing, sneezing, lifting, or exercising.   The cause of this problem is usually weakening of the sphincter muscles that allow you to hold urine in your bladder.
 
There are a few factors that contribute to stress incontinence:

1. Age – As women get older, especially as the enter and go through menopause, we lose the protective effect of estrogen which strengthen and protects urinary and vaginal function during child-bearing years.  

2. Obesity – Being overweight, especially in the abdomen, causes an increase in the resting pressure on the bladder and urinary tract walls. 

3. Type and number of pregnancies – Multiple pregnancies increase the risk of stress incontinence because of the same reason listed in #2, but there is also an increased risk if there were any instruments, such as forceps, used during a vaginal delivery. 

4. Previous surgeries on the reproductive or urinary systems – Having a hysterectomy or other surgeries on the bladder or urethra can increase the likelihood of developing stress incontinence.  While the problem is much more common in women, men too can develop stress incontinence, especially after prostate surgeries.  

5. Urinary tract infections- Bacteria that latch on to the lining of the urinary tract can irritate the sphincter muscles and cause a temporary type of leakage.  

So, what can be done to control these types of symptoms?  The first step would be an exam by your primary care doctor.  He or she will screen you for conditions that may predispose you to stress incontinence.  You will also likely receive a physical exam with specific attention paid to the reproductive and urinary organs as well as a detailed neurologic exam.  Your doctor will likely also perform a urinalysis to rule out infection.  If your exam is normal and you don’t have an infection, your doctor will likely suggest a consultation with a urologist; a doctor who specializes in disorders of the urinary tract.

The urologist can take pictures and measure pressures within your bladder musculature to determine what type of treatment you need.  Depending on the severity of your condition the doctor may recommend as little as lifestyle modifications including weight loss,  Kegel exercises, smoking cessation, and modification of your fluid intake.  If the condition is more severe, the doctor may recommend a certain type of device used to support the bladder called a pessary or a urethral insert.  In the worst cases, there are several surgical options to help control these symptoms.  

Stress incontinence can cause other complications such as skin rashes, anxiety and impaired personal relationships.  The first step in correcting the problem, however, is overcoming the embarrassing nature of the condition and having a discussion with your doctor.  Join the Kris Jenner movement and stop hiding behind your Poise pads!

Riverhead recently welcomed the only robotically-trained female board-certified urologist in Suffolk County. “ Dr. Jennifer Hill can be found at 34 Commerce Drive Suite 1 in Riverhead, NY 11901.  You can make an appointment by calling 631-284-9494.

For more information on urinary incontinence, see this article published by  The American Urologic Association. 

Alexis Hugelmeyer, D.O. is the wife of Michael, mother of Isabella, 5, and Lance, 2, and a family physician whose passion is hands-on manipulation for treatment and healing of any and every type of medical problem. She is administrative director of medical education and internship director at Peconic Bay Medical Center and also a private practitioner in Riverhead. A graduate of Villanova University and New York College of Osteopathic Medicine, she lives in Baiting Hollow.

Look for Dr. Mom every Saturday on Riverheadlocal.com

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