Shout it from the rooftops, ladies: urinary stress incontinence is not an inevitable part of aging, according to a report from the University of Michigan National Poll on Healthy Aging.
What’s urinary stress incontinence? The kind of leakage that happens when you laugh, sneeze, cough, jump, lift, exercise, or simply stand.
Nearly half of women age 50 and older report this kind of bladder leakage as a major problem, according to the survey. Avoiding a discussion on the topic seems to be rampant, too, as the report also states that nearly two-thirds of those women experiencing leakage issues don’t bring it up with their primary care physicians.
Why aren’t women talking about this, either among themselves or with their clinicians?
“Urinary incontinence is considered a bit of a taboo subject,” said urologist Dr. Richard Kershen of the Hartford HealthCare Tallwood Urology & Kidney Institute. “They’re afraid to initiate the discussion because they are embarrassed.”
There is also the secondary consideration that many women believe that urinary stress incontinence is a normal part of aging.
“Some women think it’s not even worth bringing up as a health issue,” Dr. Kershen said. “It’s too bad, because it’s such a treatable condition.”
Why does it happen?
“Part of it is genetics. There’s a certain familial predisposition to having urinary leakage issue after pregnancy and childbirth, ” said Dr. Kershen. “So if your mother had incontinence, you’re substantially more likely to suffer from (stress urinary) incontinence.”
Overall pelvic health and muscle tone also play a role.
“People who don’t perform regular fitness and exercise, and those who are overweight have a higher risk of being incontinent,” noted Dr. Kershen.
Preventing urinary stress incontinence is aided by the general rules of good health: eating right, with a specific focus on cutting out caffeine and carbonated beverages; and exercising, including daily, repetitive contractions of the muscles that control the flow of urine. These are known as pelvic floor, or Kegel, exercises.
If you are already experiencing stress urinary incontinence and these behavioral changes haven’t helped, Dr. Kershen suggests talking to your primary care physician right away about additional treatment options, the most common of which is the pubovaginal sling.
“(The pubovaginal sling) is one of the most effective treatment methods,” said Dr. Kershen. “It is the gold standard, and extremely safe.”
The sling, performed using mesh material or materials harvested from the woman’s own body, helps support a weakened of the urethra to help prevent it from opening when it shouldn’t.
A third treatment method is the injection of a bulking agent. It is an office-based procedure that helps patients receive treatment for urinary stress incontinence without undergoing surgery.
“A urethral bulking agent acts as a tissue filler that we can inject directly into the urethra under local anesthesia,” said Dr. Kershen.
The first step, though, is to talk about it with your primary care physician, who may refer you to specialist, such as Dr. Kershen.
“You want to hear what the options are, and then you need a referral to a specialist,” such as a urologist or a urogynecologist, he said. “We have expertise in correcting these problems.”