How to Deal with Stress Urinary Incontinence

Stress urinary incontinence (SUI), also known as effort incontinence, is the unintentional loss of urine. It is essentially due to insufficient strength of the pelvic floor muscles and is provoked by a physical movement or activity (such as coughing, sneezing or exercising) that puts pressure (stress) on the bladder. It can be a common and distressing problem, which may have a profound impact on quality of life. It almost always results from an underlying treatable medical condition but is under-reported. Being overweight can increase your chances of experiencing SUI due to the accumulation of extra weight in the midsection. When you carry excess weight in your abdominal area, the extra pounds put added pressure on your bladder. The extra pressure makes your bladder more likely to leak.

Bladder symptoms affect women of all ages. However, bladder problems are most prevalent among older and obese women!! Up to 35% of the total population over the age of 60 years is estimated to be incontinent, with women twice as likely as men to experience incontinence. Bladder control problems have been found to be associated with higher incidence of many other health problems such as obesity and diabetes. Stress incontinence occurs because of poor function in the muscles that support the bladder or control the release of urine. Sometimes both muscle groups are involved. The bladder expands as it fills with urine, but valve-like muscles at each end of the urethra — the short tube through which urine flows to exit your body — normally stay closed, or contracted, preventing urine release until you reach a bathroom. When the muscles supporting the bladder are weak, however, pressure can trigger urine release before you're ready. Problems with the valves themselves (the urinary sphincters) may have the same effect.

[Read: Symptoms of Urinary Incontinence]

“I am ashamed to talk about it”, that’s what I hear each day from my patients in my bariatric practice. People should understand that SUI is not a non – curable disease; there are a list of treatment options ranging from conservative treatment, behaviour management, bladder retraining, pelvic floor therapy, medications and surgery. One of the most common treatment recommendations includes exercising the muscles of the pelvis. Kegel exercises may strengthen a portion of the affected area.  Patients younger than 60 years old benefit the most. The patient should do at least 24 contractions daily for at least 6 weeks.

[Read: Treatment for Urinary Incontinence]

Healthy lifestyle practices can go a long way toward easing symptoms of stress incontinence.

• Shed extra weight- If you're overweight — your body mass index (BMI) is 25 or higher — losing excess pounds can help reduce the overall pressure on your bladder and pelvic floor muscles. Losing 5 to 10 percent of your body weight may help improve your stress incontinence considering weigh loss surgery if your BMI is more than 35.
• Add fiber to your diet- Constipation contributes to incontinence, especially if you often strain during bowel movements. Keeping your bowel movements soft and regular allows urine to flow freely and reduces the strain that's placed on your pelvic floor muscles. Eat high-fiber foods — whole grains, legumes, fruits and vegetables — to relieve and prevent constipation.
• Avoid eating or drinking substances that can irritate your bladder - For instance, if you know that drinking coffee throughout the day tends to make you go to the bathroom more frequently, try reducing the amount you drink.
• Maintain proper fluid intake - Drinking too much fluid can make you urinate more frequently. But not drinking enough can lead to a concentration of waste in your urine, which can irritate your bladder, too.
• Don't smoke - Smoking can lead to a severe chronic cough, which can aggravate the symptoms of stress incontinence.

Dr. Atul Peters, Director – Bariatric, Metabolic & Minimal Access Surgery, Fortis Shalimar Bagh.

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