Bladder - Stress Incontinence
an article by Susun S. Weed
0 . Do Nothing
Do drink enough. But limiting fluids, especially
before exercise, can help if you are dealing with
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.1
*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.2
*Stress incontinence is common after prostate surgery.
2. Engage the Energy
remedies for those with stress incontinence include
Causticum, Pulsatilla, and Belladona. The last is
specific for women whose incontinence occurs after
childbirth or surgery.
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.
Women with stress incontinence who wear a tampon
when they exercise stay significantly drier.3
Topical vaginal estrogen cream may relieve your
stress incontinence, especially if menopause aggravated
Step 5b. Use Drugs
Actually, dont 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.4
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.
injections, used to bulk up weakened bladder muscles,
have to be repeated every six months, can cause
allergic reactions, and generally provide only partial
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
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.6,7 Ferdinand
Frauscher, MD, of Innsbruck, co-developer of the
technique says: The whole procedure
takes just 10-15 minutes. It reverses the effects
8 Most women (80%) retained complete bladder control
for a year afterward; long-term data not available.
loss, even as a result of bariatric surgery, reduces
the severity of both urinary and fecal incontinence.9
having a C-section instead of a vaginal birth will
protect you against later incontinence? It wont.10,11
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.12 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.13
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
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
Meta-study led by Jeanette S Brown MD, reported
in Bottom Line Health, December 1, 2000.
2. American Journal of Obstetrics and Gynecology,
3. Exercising with incontinence, Health, 1999.
4. Our Bodies Ourselves for the New Century
5. Radio waves treat stress incontinence,
Journal of Urology, March 2003, reported in Health
News, June 2003.
6. Stem cells may treat incontinence, Womens
Health Advisor, July 2006.
7. (4) New Scientist, Dec 2004.
8. (27) New Scientist, Dec 2004
9. Obstetrics & Gynecology, Nov 2007, 110:1034.
10. Ibid (Obstetrics & Gynecology, Dec 2006).
11. Vaginal delivery not associated with urinary
incontinence, Womens Health Activist,
12. Journal of Urology, May 2002.
13. Hysterectomy and urinary incontinence:
a systematic review, The Lancet 2000; 356
Aug 12, 2000.
14 Help for bladder problems, More,
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