Department of Obstetrics and Gynecology

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Incontinence In Women

Urine loss that you are unable to control is called incontinence. There are three major types of incontinence:

• stress incontinence

• irritable bladder and

• chronic urethritis

STRESS INCONTINENCE is caused by weak pelvic floor muscles. This commonly occurs after childbirth or due to obesity. At menopause the ovaries stop making estrogen resulting in weakened muscles that may cause drooping of the womb or vagina. Coughing, laughing, or sneezing may cause a sudden loss of urine.

With an IRRITABLE BLADDER you get sudden spasms that cause you to release urine unexpectedly. You may wake up several times in the night needing to go to the bathroom. Usually this condition is caused by a bladder infection.

CHRONIC URETHRITIS is inflammation of the tube that delivers urine from your bladder to the outside. This tube may be irritated by chemicals such as bubble bath or spermicides. Bruising from intercourse may also cause it. More often, it is caused by an infection with Chlamydia.

Determining the cause of your incontinence is important. Tests may include:

• a urine exam

• an X-ray of your bladder

• an examination of the inside of your bladder with a scope and

• urodynamic testing where your bladder is filled and the pressure is measured

TREATMENT depends on the cause of the problem. Taking drugs to treat infections results in a quick decrease in symptoms. Pelvic muscle exercises can provide steady improvement in those with mild urine loss.

Many people may benefit from exercises known as Kegel exercises that strengthen the pelvic floor muscles. To do these, pretend that you are trying to stop from passing gas. Squeeze the muscles you would use. Hold for a count of 3. Relax for 3 counts and then repeat as many times as you are able. Practice the exercises while doing other things, such as watching television, riding in a car, or making a meal. Do not practice these while you are urinating, because they could actually weaken the muscles. Pelvic floor exercises, like most exercises, should be a lifelong practice.

Losing weight helps decrease pressure on the bladder. A combination of these treatments may be required. Sometimes drugs are needed to relax or reduce the nervous stimulation of the bladder. Other times surgery may be required to lift the supporting structures of the bladder.

There are many ways to treat incontinence. Even if treatment is not helpful, there are ways to manage it, such as:

• always wear a pad in case of accidents

• decrease the fluids you drink prior to bedtime

• always empty your bladder as much as possible and

• empty your bladder before events that are likely to cause leakage

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