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“Nancy,” age 55, quit playing tennis because her sudden stops and starts on the court caused leaking urine. Coughing and sneezing often created embarrassing moments in social settings. She carried a change of clothes everywhere and began going out less and less. Nancy is among an estimated 15 million American women who have stress urinary incontinence, a lack of bladder control with sudden movements like running, jumping, and laughing.
Stress incontinence is one of a group of conditions called pelvic floor disorders, problems resulting from weakening of the slingshaped muscles and ligaments that support the uterus, bladder, and bowel. Two other common pelvic floor disorders in women are urge urinary incontinence, also called overactive bladder, and pelvic organ prolapse, in which the pelvic organs drop into the vagina and create a bulging pressure.
These problems most often affect women in their 60s and older but can also occur in younger women. Although not life-threatening, pelvic floor disorders can cause discomfort and limit a woman’s ability to do physical and social activities she enjoys.
Urogynecologist Jennifer Yeung, DO, with TriHealth’s Cincinnati Urogynecology Associates, encourages women to speak up about their experiences. “Women can help each other deal with something that’s very embarrassing and adversely affecting their quality of life. Seeking treatment early may allow women to achieve better outcomes,” she continues.
“Women tend to be very good caretakers of everyone else,” Dr. Yeung says. “I’d like to empower women to practice more self-care. If they come in and are motivated, we will work with them to find something that works to help them.”
Dr. Yeung and her fellow urogynecologists partner closely with patients to evaluate treatment options and develop a plan.
She often recommends pelvic floor physical therapy for both incontinence and prolapse. “Women who make the time commitment say it helps a lot,” she notes. Physical therapy can strengthen weakened muscles or relax spasming muscles. Medications also can be helpful.
For pelvic organ prolapse, some women choose a pessary, a silicone ring that is placed in the vagina to hold pelvic organs in place. Others with more severe symptoms may choose robotic or vaginal surgery to reconstruct the vagina.
Severe cases of overactive bladder may require injecting Botox into the bladder to relax muscles or implanting a sacral nerve stimulator to reduce muscle spasms.
Stress incontinence surgery often involves implanting a mesh sling to support the urethra (tube that carries urine from the bladder) to keep the urethra closed during physical activity so it doesn’t leak.
Although aging, hormonal changes, family history, and childbirth can predispose women toward pelvic floor problems, Yeung says that all women can take steps to protect against incontinence and prolapse. She offers these helpful tips:
Use proper lifting techniques and limit repetitive lifting.