February 15th 2012 - STEP 0. DO NOTHING
Do drink enough. But limiting fluids, especially before exercise, can help if you are dealing with stress incontinence.
STEP 1. COLLECT INFORMATION
Repeated childbearing can weaken pelvic muscles. And some birthing situations make it more likely.
Women who receive an epidural, or who deliver by C-section, are twice as likely to have stress incontinence as they age.
Women who tuck their chin and hold their breath during the peak of a labor contraction (coached pushing) give birth more quickly, but increase their risk of stress incontinence.
Stress incontinence is common after prostate surgery.
STEP 2. ENGAGE THE ENERGY
Homeopathic remedies for those with stress incontinence include Causticum, Pulsatilla, and Belladona. The last is specific for women whose incontinence occurs after childbirth or surgery.
STEP 3. NOURISH AND TONIFY
Absolutely nothing is as effective in restoring tone to weakened muscles as exercise. Pelvic floor exercises/Kegels are a must for any woman (or man) bothered by stress incontinence, prolapse, or just a desire for stronger orgasms. Dr. Kegel referred to stress incontinence as “pelvic fatigue syndrome.”
STEP 4. STIMULATE/SEDATE
Women with stress incontinence who wear a tampon when they exercise stay significantly drier.
Topical vaginal estrogen cream may relieve your stress incontinence, especially if menopause aggravated it.
STEP 5B. USE DRUGS
Actually, don’t use drugs. With the possible exception of dulaxetine - an antidepressant which blocks re-uptake of serotonin and norepinephrine in the spinal cord, thus stimulating the nerve that contracts the urethral sphincter - prescription drugs are not effective in relieving stress incontinence.
“Getting help when surgery is needed can be challenging, because female reproduction and urology are separate medical specialties. Urologists know little more than the basics about female reproductive organs, while few doctors in either specialty know much about treating middle-aged and older women.”
STEP 6. BREAK AND ENTER
Surgery to resolve incontinence is neither easy nor always successful. If you do decide to go for it, a urogynecologist - someone who specializes in female urinary problems - is preferred.
Collagen injections, used to bulk up weakened bladder muscles, have to be repeated every six months, can cause allergic reactions, and generally provide only partial relief.
Trans-vaginal radio frequencies, applied by means of a thin probe inserted into the vagina during a minor surgical procedure, heat up and break down pelvic floor muscles, which heal tighter and more in control. Three-quarters of a group of 109 women who had the procedure were completely continent or had improved at the year follow-up.
A new surgical option is so simple, it may revolutionize the treatment of stress incontinence. Under local anesthesia, a muscle biopsy is cut from the biceps. The myoblasts (cells) thus obtained are grown for six weeks until there are 60 million of them. Injected into the muscle that controls the flow of urine, they proliferate and rebuild the sphincter, restoring full bladder control in 90% of the women within 24 hours. , Ferdinand Frauscher, MD, of Innsbruck, co-developer of the technique says: “The whole procedure … takes just 10-15 minutes. It reverses the effects of aging …” Most women (80%) retained complete bladder control for a year afterward; long-term data not available.
Weight loss, even as a result of bariatric surgery, reduces the severity of both urinary and fecal incontinence.
Think having a C-section instead of a vaginal birth will protect you against later incontinence? It won’t. ,
A hysterectomy may help - but only if you are already incontinent. In a study of 1200 women, 89% of those with severe, and 62% of those with moderate, incontinence experienced improvement after a hysterectomy. However, 17% of those with mild or no prior incontinence experienced leakage in the year after surgery. And a review of 30 years of journal articles found that, in general, middle-aged women with hysterectomies had a 60% higher risk of incontinence later in life.
The two most common surgical corrections for weak pelvic muscles are the Burch and the Sling. In one head-to-head study, at the two-year follow-up, 49% of those who had the simpler Burch - which uses stitches to lift the pelvic floor, like a face lift - were dry, as compared to 66% of those who had the more invasive Sling - in which a small piece of abdominal tissue is looped under the urethra and sewn onto the abdominal wall.
Everyone who is incontinent has weak muscles. The difference is that those with stress incontinence “deny the problem, pay little attention to bladder signals, and are surprised when a slight physical exertion forces urine out of the bladder. The urge patient, on the other hand, is preoccupied with bladder signals … and rushes to the toilet at the first signals. …the brain learns to stop inhibiting the reflexive contractions of the bladder …”
Leslie Talcott, director of Perineometer Research Institute
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