Katrina Davis M.D.,
Do you leak urine when
you cough or sneeze? Have you stopped jogging or playing
your favorite sport out of embarrassment of wet clothing
when you finish? Are you afraid to leave the house
without wearing a pad? If this describes you, then you
stress urinary incontinence.
More common in women
than in men, there are a few different types of urine
leakage. Urinary incontinence effects 1 in 3 female
adults and becomes more common as women get older.
Stress urinary incontinence or SUI means that you leak
urine when the pressure within your abdomen increases
and therefore pushes down on the pelvic floor including
your bladder and urethra (tube through which we
urinate). Sometimes the urethra is too mobile or can’t
clamp down and therefore you leak.
Women who are
overweight, smoke cigarettes, do a lot of heavy lifting
or have had children are more likely to develop it. Also
women who have conditions that make their muscles weak,
like the disease Myasthenia , have an increased chance
of having this problem.
Symptoms of SUI can be
mild with occasional accidents or severe with daily
leaks. Over time, accidents tend to become worse and
more frequent. Fortunately, there are several ways to
treat this problem.
One thing that can be
done is to make the muscles in the pelvic floor
stronger. A professional can work with you to show you
exactly how to squeeze the pelvic muscles to get the
best results. This usually takes several treatment
sessions in the clinic setting and then a home program
is eventually prescribed.
Another treatment is a
small object called an incontinence dish. The dish is a
plastic ring that when placed inside the vagina rests
beneath the urethra to hold it steady during activities.
It has to be removed every so often to be cleaned and
then needs to be replaced to continue to work.
A third treatment is a
procedure called urethral bulking. This can be performed
in the office with no downtime. After the urethra is
numbed, a camera for the bladder called a cystoscope is
used to guide the injection of a material into the wall
of the urethra. Since the urethra is like a tube, the
material causes the opening to narrow and makes it less
likely that urine will leak.
An additional option is
placement of a sling. This is usually an outpatient
surgery. There are several types of sling available.
They typically involve an incision inside the vagina but
depending on the type of sling placed, may also require
additional incision(s) in the groin or low on the
abdomen near the pubic bone. A small strip of permanent
material called mesh is placed under the vaginal skin to
give support to the urethra like a hammock.
A final and more recent
treatment available is vaginal laser. This can be
performed in the office with no downtime. After numbing,
a metal tube is placed in the vagina and used to direct
laser energy. The laser energy heats the vaginal skin
under the urethra and makes it grow and become stronger.
is a 45
year-old who leaked urine when she exercised. She spoke
with her doctor and decided on vaginal laser treatment.
She had the laser procedure performed one morning before
work and continued to the office to complete her day.She
is now able to exercise again without fear of accidents
or need for a pad.
There are many options
for women diagnosed with SUI. Each has its place
depending on the patient and her circumstances. The
important thing is to speak with your doctor about this
to determine which is best for you.
Call Central Florida
UroGynecology in Rockledge 321-806-3929 or check us
Marja Sprock, M.D
and Katrina Davis M.D. are board certified in OB/GYN and
Female Pelvic Medicine and Reconstructive Surgery (Urogynecology)
and are offering academic level medicine in a private
Florida UroGynecology where high tech and common sense