Ok….call me ridiculous……..and lots of folks do, but I was literally just deciding on what to write about Stress Incontinence when that Nelly song popped into my mind, you know the one, “Drop down and get your Eagle On”? I started groovin’ to this jam and thought how it might apply to the GYN realm.
Well, here you have it, Drop Down and Get Your Kegel On!
Before everyone starts contracting their pelvic floors, a few facts about GSUI…..
First off, what is it?
Let me start by saying, not nearly as uncommon as you think. I have folks, young and old alike, who complain of this. That being, leaking urine with coughing, laughing, sneezing, lifting heavy objects…….Basically, leaking small amounts of urine with ANYTHING that increases your intra-abdominal pressure…..Poise Pad anyone?!?!?
DON’T BE EMBARRASSED! Again, this is a lot more common than you think…..more soccer moms than you realize are experiencing this same thing! I mention soccer moms, not because I’m picking on soccer moms, but because moms in general are oft times affected by this.
IT’S THE BIRTH OF THE CHILDREN that is a risk factor. Women may find they have a “looser” vagina after birth, especially if they have had long second stages of labor, i.e. had to push A LOT to deliver their children vaginally. This is NOT uncommon. All that pushing can weaken the pelvic floor musculature. Other risk factors for stress incontinence include:
- being overweight
- consuming too much caffeine
- having a job or doing repetitive activities that require a lot of heavy lifting
- anything that might increase coughing: chronic lung conditions, smoking, etc.
What to do?!?!? TELL YOUR DOCTOR! The conversation will likely hit on how long you’ve been experiencing said symptoms, if there are any mitigating factors, how THIS is affecting your quality of life, if there are any associated symptoms such as pain, pressure, etc?
If this is a straight forward case of stress incontinence, and in most cases it is, nothing beyond a basic physical exam, and urine analysis(always gotta rule out an underlying infection) will be necessary for the workup. I usually don’t recommend urodynamics(bladder testing) unless I suspect that things are “more involved”.
Treatment options are NUMEROUS and include things such as
- Kegels: LOVE these! Thing is, most folks don’t do nearly enough, or do them long enough! These are NOT going to work overnight! My usual recommendation is at least 50 per day(do them in sets of 10), and don’t tell me you don’t have time…..you can literally do them ANYWHERE! At the desk, traffic light….HELL, I’m doing some as I type this piece(smile). Don’t expect to see any results for at least 6 – 8 weeks.
- Pessaries(nice option to avoid surgery……..helpful in supporting the bladder neck)
- Injectables(minimally invasive procedure; not a permanent fix)
- Surgery(there are more options than just MESH! Talk to your gyn about this)
- Lifestyle modifications: weightloss, smoking cessation, decreasing caffeine intake, etc.
- Urethral Inserts(I recently saw a commercial advertising these….it’s like putting a tampon inside your urethra for recreational purposes…….I don’t know anyone that has tried this….I do know that it doesn’t sound like much fun…YIKES!)
WHATEVER you decide to do, do something. If you are good with wearing a pad, just make sure you change them frequently as constant moisture on the skin “down there” is a set up for vaginitis……..We all know what that means, itching, burning, perhaps odor, skin break down…..
Hoping this blog post has added value to your day!
HAPPY 2016!
Until next time,
Look Better. Feel Better. Be Better.
Dr. Angela
