Do you remember the days when you didn’t have to worry about peeing your pants whenever you run, exercise, cough, sneeze or even laugh?
How is this affecting your life? Your self-esteem?
If a leaky bladder is causing you shame or embarrassment, you are not alone. These are symptoms of a form of urinary incontinence called stress urinary incontinence (SUI).
SUI is the most commonly occurring form of urinary incontinence in women under age 60. It is estimated that 30% of women between the ages of 30-60 suffer from it. There is a myth that these symptoms only happen to older women who have had children. Yet studies have shown that greater than one in four female college athletes suffer from stress urinary incontinence.
Urinary incontinence is more common than many of the chronic diseases you commonly hear about. Unfortunately, most women who suffer from these symptoms do so in silence never seeking solutions.
What Causes a Leaky Bladder?
Both the loss of integrity of the collagen that makes up the vaginal wall and pelvic floor muscle weakness contribute to urinary incontinence. And that’s not all. Thinning of the collagen in the vaginal wall also contributes to sexual dysfunction including dryness, sensitivity during sex, and loss of sexual desire, and inability to orgasm by causing vaginal laxity.
Both of these weaknesses make the pelvic floor, urethra, and bladder more sensitive to the pressures around them resulting in bladder leakage. At Osteopathic Integrative Medicine, where I practice in Lakewood, Colorado, many of our female patients have noticed connections between their pelvic floor weakness and core stability.
They realized that their core could not be strong no matter how much they exercised it with a weak pelvic floor. Some described feeling better posture and feeling like their belly no longer “pouched” outward once they strengthened their pelvic floors.
Common causes that can affect the vaginal wall collagen and pelvic floor muscle strength are pregnancy, childbirth, weight gain, aging, menopause, genetics, heavy lifting activities, and smoking. Hormonal deficiencies or imbalances affecting estrogen can also cause vaginal wall thinning.
How Can You Fix Bladder Leakage?
A surgical procedure is available to fix stress urinary incontinence. It works by inserting a bladder “sling”—a piece of tissue or material that holds up the bladder and prevent leaks. There has been a lot of litigation with the slings and sling surgery is banned in certain countries around the world.
If you’re like many women, this type of surgical procedure may not be your preferred method for fixing bladder leakage caused by SUI. So what are your other options?
7 Non-Surgical Fixes for Stress Urinary Incontinence
There are multiple solutions for leaky bladder caused by SUI, along with the pros and cons of each.
1. Living with it
Unfortunately, many women feel like they have no choice but to live with their SUI. Wearing pads does not improve the problem and often negatively affect a woman’s quality of life.
When you stop socializing, avoid and become anxious about intimacy with your partner, change your wardrobe multiple times a day, and make other similar changes out of embarrassment from your problem, you might be “living with it,” but at what cost?
Pads are a strategy to deal with it, but they are not a treatment strategy. When factoring in the cost of pads, laundry/dry cleaning, paper towels, and toilet paper, incontinence can cost upwards of $900 or more per year. This is the physical cost of this strategy. The emotional cost of losing self-confidence, anxiety, isolating behaviors, etc, is much more.
The class of medications used to address urinary incontinence is generally called anticholinergic medications. They are usually in pill or patch form. They work by blocking the nerves that trigger the contraction of the bladder muscle. These types of anticholinergic medications do have a few common side effects, including dry mouth and constipation.
For an overactive bladder, there is a medication available that works by relaxing the bladder muscle and increasing the amount of urine the bladder can hold. By holding urine in the bladder longer, it makes a woman more prone to urinary tract infections. The most common side effects of this type of medication is increased blood pressure, common cold symptoms, and headaches.
3. Vaginal Inserts
Another method used to control urinary incontinence is with vaginal inserts such as pessaries. A pessary is a silicone device inserted into the vagina putting pressure on the vaginal wall to push the urethra closed. This can effectively close the urethra, but constant pressure on a tissue can get very uncomfortable over a long period of time.
The cons with pessaries are that they commonly cause vaginal irritation, discomfort, foul-smelling discharge, and urinary tract infections.
4. Invasive Procedures
A more invasive non-surgical procedure is called bulking therapy. This is where a gel-like material is injected into and around the urethra just outside of the bladder. It can be done in an outpatient or as an office-based procedure. The intention is to boost the size of the lining of the urethra and to limit the amount of urine that can escape the bladder.
Bulking therapy requires repeated injections every 12-18 months and so the efficacy can vary. There is always a risk of damaging the urethra. It only addresses stress urinary incontinence, but no urge or mixed incontinence. Just like with the pessaries that create retention, this can create a higher risk of urinary tract infections. Also injecting foreign substances can cause immune reactions.
5. Pelvic Floor Physical Therapy
A common non-invasive method to address pelvic floor weakness to resolve urinary incontinence is with pelvic floor therapy. Patients will work with a physical therapist and usually attend in-office visits 2-3 times per week for about 12 weeks. Treatment requires internal manual digital manipulation of the vagina.
The common issues that come with pelvic floor physical therapy are maintaining compliance due to having to go multiple times per week. There are questions about the long term efficacy, especially if a patient does not continue doing the exercises at home.
Some other complaints I have heard from patients is that pelvic floor physical therapy is fairly intimate and can be uncomfortable. Patients are often unclear if they were doing the exercises correctly.
6. Ablative Lasers
A final category is ablative lasers. These can involve radio frequency, CO2, or Erbium. These work by heating the vaginal wall tissue and triggering a regenerating effect of the collagen in the vaginal wall. All of these, except one, require a probe that contacts the vaginal wall that must be constantly moved because it will burn the tissue if not and require multiple visits. By moving constantly, they cannot heat very deeply and that is the need for multiple visits. This can make the procedure uncomfortable and require skilled technicians to perform the procedure safely. The full effect of these treatments can take up to 6 months.
7. A Combination Approach
- A one-time, painless, non-surgical session that works to restore the collagen of the vaginal wall.
- An easy to use at-home pelvic floor physical therapy device.
I’ve found the combination of these two to be highly effective in restoring the structural integrity of the vagina, pelvic floor, urethra, your core, and more to help bring an end to sexual dysfunction, stress urinary incontinence, urge incontinence, mixed incontinence, and more.
You Don’t Need to Suffer from Bladder Leaks and Embarrassment
If you suffer from urinary incontinence and suffer in silence, you are not alone. Millions of women suffer from these issues. There are a lot of great options now to address urinary incontinence that was not available to previous generations. There is no longer a reason to suffer in silence.
Dr. Daniel Lopez is an osteopathic doctor that specializes in helping people feel better inside and out. Download his free ebook, Stop the Bladder Leak, to learn ways you can stop feeling shame about your leaky bladder and get back to enjoying your life.