Urinary Incontinence - it's common, 1 in 4 women will experience it. We don't talk about it nearly enough, let's normalize things women experience!
When I would sneeze, cough, jump, or run/walk fast I leaked urine. Well isn't that just great! Especially when you're in the middle of an hour long hip hop dance class that includes lots of jumping and high impact work. I emptied my bladder before the class, tried not to drink too much water during the class and even visited the bathroom during a quick break...still uncontrollable leaking.
Sure I've heard of kegels and pelvic floor physical therapy but are you telling me that I need to add this to my daily routine on top of getting enough sleep, eating healthy, drinking enough water, exercising, keeping the house clean, teaching my kids sight words to get ready for Kindergarten, feeding them healthy food, limit screen time, keep in touch with friends and family, plan family trips/activities, and don't forget about self care! Besides the time commitment of pelvic floor physical therapy, does insurance even cover it? Not mine.
I guess I just thought after you had kids that this was normal. Women don't talk about urinary incontinence very much and when we do it's in a joking way like "oh honey I can't jump on the trampoline with you because I might pee myself". Since this was causing a disturbance to my everyday life I chose to see a Urogynecologist. I did some (very uncomfortable) tests and confirmed I had stress incontinence. Which I could've told you without having to fill my bladder like a water balloon and hooking me up to multiple catheters with sensors (going all kinds of places!) Based on my frequency and urgency my doctor informed me I have overactive bladder as well. Great double whammy!
There are two common types of incontinence = Stress Incontinence and Urge Incontinence
Urinary incontinence is usually caused by problems with the muscles and nerves that help the bladder hold or pass urine. Certain health events unique to women, such as pregnancy, childbirth, and menopause, can cause problems with these muscles and nerves.
Stress incontinence. Urine leaks when you exert pressure on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy.
Urge incontinence. You have a sudden, intense urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night. Urge incontinence may be caused by a minor condition, such as infection, or a more severe condition such as a neurological disorder or diabetes.
Mixed incontinence. You experience more than one type of urinary incontinence — most often this refers to a combination of stress incontinence and urge incontinence.
Urinary incontinence can be a persistent condition caused by underlying physical problems or changes, including:
Pregnancy. Hormonal changes and the increased weight of the fetus can lead to stress incontinence.
Childbirth. Vaginal delivery can weaken muscles needed for bladder control and damage bladder nerves and supportive tissue, leading to a dropped (prolapsed) pelvic floor. With prolapse, the bladder, uterus, rectum or small intestine can get pushed down from the usual position and protrude into the vagina. Such protrusions may be associated with incontinence.
Changes with age. Aging of the bladder muscle can decrease the bladder's capacity to store urine. Also, involuntary bladder contractions become more frequent as you get older.
Menopause. After menopause, women produce less estrogen, a hormone that helps keep the lining of the bladder and urethra healthy. Deterioration of these tissues can aggravate incontinence.
I've had urinary incontinence since my first childbirth however, I noticed it getting much worse after my second birth in 2018 and into 2019/2020 when I now think I was beginning peri menopause. I struggled to walk from dinner at a restaurant with friends to a nearby bar or restaurant without leaking urine. I couldn't run, jump to do most of the physical activities I liked to do, like hip hop cardio dance. I finally decided to see a Urogynecologist and seek treatment.
Treatment options depend on the type, the severity, and the underlying cause:
Behavioral Techniques - bladder training, double voiding, diet management
Pelvic Floor Therapy - To help you identify and contract the right muscles, your doctor may suggest that you work with a pelvic floor physical therapist
Medications - there is medications that can help calm an overactive bladder, or relax the bladder muscles so you can increase the amount your bladder can hold, a topical estrogen may help tone and rejuvenate tissues in the urethra and vaginal areas.
Interventional Therapies - bulking material injections, nerve stimulators, or Botox
Surgery - if other treatments aren't working there are several surgical options: sling procedures, bladder neck suspension, prolapse surgery.
I chose to do interventional therapy - bulking material injections. It's a synthetic material that is injected into tissue surrounding the urethra. The bulking material helps keep the urethra closed and reduce urine leakage. This procedure is for the treatment of stress incontinence and is generally less effective than more-invasive treatments such as surgery. It may need to be repeated more than once. I've always thought I have a high pain tolerance but this procedure hurt like hell and I don't plan on getting it done again - if I continue to have issues I will eventually have the sling surgery! I have a girlfriend that had the surgery done by my same doctor (she recommended him) and she said it has been amazing, back to working out running/jumping etc with no leaking issues! The sling procedure is a synthetic material (mesh) or strips of your body's tissue are used to create a pelvic sling underneath your urethra and the area of thickened muscle where the bladder connects to the urethra (bladder neck). The sling helps keep the urethra closed, especially when you cough or sneeze. I'm also taking a medication for the urge incontinence which helps calm an overactive bladder.
If you are experiencing any of the symptoms above I definitely encourage you to seek out your treatment options. In my journey I quickly realized you have to advocate for yourself, find a doctor that will listen and help you determine what treatment plan is right for you based on your circumstances! Also, know that although it's common you don't have to accept it for your indefinite future!
*select information & image provided by Mayo Clinic website
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