So you leaked a bit. Here’s what to do about it.
Some surprises, like when your spouse makes you breakfast in bed or when the barista randomly gives you a latte on the house, are great. Other surprises, like when you have a sneeze attack and then, er, pee yourself a bit … are not so great.
Peeing in your pants a little, while embarrassing, is totally normal. It’s called stress incontinence when the bladder leaks urine while under increased pressure, like when you exercise, lift something heavy, sneeze, or even when you’re having sex.
Stress incontinence can occur if the urethral wall, urethral sphincter, or pelvic floor muscles are weak. Women who’ve been pregnant, given birth, gone through menopause, or are overweight or have diabetes are at an increased risk for stress incontinence. “It’s very common to have a leaking of urine after you have a vaginal delivery,” says Jennifer Wu, MD, an ob-gyn at Lenox Hill Hospital. “This is because the pelvic supports have had some stress.”
While some women regain bladder control within a couple months after having a baby, it’s not uncommon to have some stress urinary incontinence for several years after childbirth. One study found that 29% of first-time mothers still had incontinence four years after delivery. “Patients may report that with any sort of increased pressure, like coughing or sneezing, they leak a little bit, even after years of having a baby,” says Dr. Wu.
Treatments for Stress Incontinence
Treatments for stress incontinence usually include lifestyle or behavior changes, and in more serious cases, surgery. “Before talking about surgery, we talk with patients about behavioral modifications and also medications that can help with the leaking of urine,” says Dr. Wu.
Here are some lifestyle tweaks that may help reduce stress incontinence:
Empty your bladder often. “A patient may want to try to keep their bladder as empty as possible, especially emptying right before exercise,” says Dr. Wu. It’s also important to urinate when you first feel the urge—don’t hold it. This may help reduce the amount of urine that leaks.
Do Kegel exercises. “[Kegels] help to strengthen the [pelvic floor] muscles so they’re better able to close the urethra in moments of stress, such as coughing or sneezing, says Dr. Wu. Here’s how to do a Kegel exercise—and also how NOT to do a Kegel exercise.
Drink the right amount of fluid. If you drink large amounts of fluid, you may find that cutting back will reduce your leakage. However, if you don’t drink enough fluid, your urine may become concentrated, which can irritate your bladder and increase the urgency to urinate. Here’s how to drink the right amount of water for your body.
If lifestyle modifications don’t help, surgery is an option for stress incontinence. “There’s surgery where we place a sling under the urethra, so when a patient coughs it helps to shut the urethra so [they] don’t leak,” says Dr. Wu.
“Many women think that urinary incontinence is just a part of the process of getting older, but they don’t realize that there are different things we can do to help them,” says Dr. Wu. “We don’t want it to impact their daily lives where they’re avoiding exercise, we really can help them with surgery and medications.”
Dr. Wu is a board-certified obstetrician-gynecologist practicing in New York City.
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It's very common to have some leaking of
urine after you have a vaginal delivery.
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This is because the pelvic
supports have had some stress.
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It's usually worse in the first six
months and gets significantly better.
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Patients may report that, with any sort
of increased pressure like coughing or
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sneezing, that they leak a little bit,
even years after having the baby.
00:00:26,280 --> 00:00:28,690
Patients are very worried by
this leaking of urine, and
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that it could become worse
sometimes with age or gravity.
00:00:31,590 --> 00:00:33,540
We usually prescribe Kegel exercises for
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patients who are having
problems with urinary leakage.
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This helps to strengthen the muscles, so
they're better able to close the urethra
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in moments of stress such as
with coughing or sneezing.
00:00:44,430 --> 00:00:46,920
Women do not have to deal
with urinary leakage.
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There are procedures that we can do
to stop the stress incontinence.
00:00:51,480 --> 00:00:55,490
There's surgery where we place
a sling underneath the urethra, so
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when a patient coughs, it helps to
shut the urethra so you don't leak.
00:00:59,660 --> 00:01:05,010
Before talking about surgery, we talk with
patients about behavior modification and
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also medications that can help
with the leaking of urine.
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For instance, a patient may want to try
keep her bladders as empty as possible,
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especially emptying right before exercise.
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And she may also wanna use estrogen
cream if she's postmenopausal.
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This well help to thicken up
the tissues around the urethra,
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which will help with
closure of the urethra.
00:01:23,820 --> 00:01:27,300
Many women think that urinary incontinence
is just part of the process of getting
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older, but they don't realize that there
are different things that we can do to
00:01:30,727 --> 00:01:31,253
00:01:31,253 --> 00:01:35,959
And we don't want it to impact their daily
lives where they're avoiding exercise.
00:01:36,959 --> 00:01:39,321
We really can help them with surgery and
00:01:39,321 --> 00:01:39,821
Bladder Control Problems in Women (Urinary Incontinence). National Institute of Digestive and Kidney Diseases. (Accessed on April 16, 2018 at https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems-women)
Stress Urinary Incontinence. U.S. Library of Medicine, MedlinePlus. (Accessed on April 16, 2018 at https://medlineplus.gov/ency/article/000891.htm)
Evaluation of women with urinary incontinence. UpToDate. (Accessed on April 16, 2018 at https://www.uptodate.com/contents/evaluation-of-women-with-urinary-incontinence)