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 pee a little accidentally, are not so great. This unwelcome surprise is called stress incontinence.
What is stress incontinence?
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.
Urinary leakage can occur if the urethral wall, urethral sphincter, or pelvic floor muscles are weak. You have a higher chance of stress incontinence if you:
- Have been pregnant or given birth, especially after a vaginal delivery
- Have gone through menopause
- Are overweight
- Have diabetes
Some women do regain bladder control within a couple months after having a baby. However, it’s fairly common to have some stress incontinence for several years after childbirth. One study found that 29 percent of first-time mothers still had incontinence four years after delivery.
What are treatments to avoid or manage accidents?
Treatments for stress incontinence usually include lifestyle or behavior changes. In more serious cases, medication and surgery are also an option.
Here are some lifestyle tweaks that may help reduce stress incontinence:
1. Empty your bladder often.
Stress incontinence is less likely when you don't have a full bladder. It’s also important to urinate when you first feel the urge, so don’t hold it. This may help reduce the amount of urine that leaks.
2. Do Kegel exercises.
Kegels may help to strengthen your pelvic floor muscles. This way, they are better able to close the urethra in moments of stress, such as exercising, coughing, or sneezing. Here’s how to do a Kegel exercise — and also how NOT to do a Kegel exercise.
3. 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.
When is surgery helpful?
If lifestyle modifications don’t help, surgery is an option for stress incontinence. In this surgery, doctors place a sling under the urethra. The sling helps shut the urethra, which helps prevent leakage.
While leaking urine is common — especially as people age — you don't have to just put up with it. There are a number of things that you and your doctor can do that may help. Talk to your doctor if you experience stress incontinence often, or if it's getting in the way of your daily living.
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.
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Patients are very worried by
this leaking of urine, and
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that it could become worse
sometimes with age or gravity.
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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.
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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.
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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.
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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.
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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
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And we don't want it to impact their daily
lives where they're avoiding exercise.
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We really can help them with surgery and
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Bladder Control Problems in Women (Urinary Incontinence). Bethesda, MD. National Institute of Digestive and Kidney Diseases. (Accessed on April 12, 2021 at https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems-women)
Stress Urinary Incontinence. Bethesda, MD. U.S. Library of Medicine, MedlinePlus. (Accessed on April 12, 2021 at https://medlineplus.gov/ency/article/000891.htm)
Evaluation of women with urinary incontinence. Chatham, MA. UpToDate, 2021. (Accessed on April 12, 2021 at https://www.uptodate.com/contents/evaluation-of-women-with-urinary-incontinence)