Leaking Urine
By Jerome Klobutcher, M.D.
Board Certified in Obstetrics and Gynecology
Samaritan Women’s Care
419-207-2513
While both men and women experience leaking urine or frequent urination, I will discuss the problem in women since I am a gynecologist.
Many women have one or the other of these problems and sometimes both, so if you have them, you are not alone! It is estimated that up to one half of women with these problems do not mention them to their doctor due to embarrassment or the misconception that it is a normal part of getting older. Interestingly, these problems can occur in relatively young women also, so they are not just a concern for “aging” women.
Why do these problems occur? Research continues to determine the causes, but the most accepted ones relate to damage to supportive tissues and nerves in the pelvis, as well as decreased blood supply to pelvic tissues.
As in many medical ailments, one can take preventive action to keep damage from occurring or attempt to fix the damage once it has occurred. It is unfortunate that the preventive approach cannot always work in relation to these urinary problems because of natural things that happen to women during their lifetimes. What I am talking about here is childbirth and hereditary factors.
Vaginal childbirth and pregnancy, carrying a growing baby within you, even if you have a Cesarean delivery, can cause changes to the pelvic floor leading to urinary problems. Hereditary factors, traits inherited from your parents, may also affect tissue strength and may be something that cannot be modified or changed no matter how many pelvic floor exercises you do.
So, what are the common urinary problems?
1) Urinary Frequency. This simply means that you feel like you are spending more time in the bathroom than you think you should. Many times this is associated with another problem - urgency.
2) Urgency. This is the need to get to the bathroom “urgently” or “right away” or else you fear that you will leak on yourself.
3) Leaking with a Physical Stress (Stress Urinary Incontinence). In this, you usually leak small spurts of urine with such things as coughing, sneezing, laughing or lifting heavy objects. Less commonly are the problems of leaking continuously or all the time and leaking even with minimal physical activities such as standing or sitting.
All of these symptoms can be investigated to see if they can be treated with something as simple as antibiotics for an infection to tighter control of blood sugar if you have diabetes, all the way to urinary bladder retraining, pelvic floor physical therapy and possible surgery for those problems that cannot be improved by any other means.
Physical therapy can often be accomplished in as little as 6-12 weeks with dramatic improvement for urge and stress incontinence. The important thing to understand with this therapy is to continue at home the things that you learned while you were in therapy.
An even more recent mode of therapy involves stimulating a nerve that helps control the bladder and thereby lessening the feeling that you need to urinate. This involves weekly visits for approximately 12 weeks.
The surgical procedures used are very frequently what we call “same day” or “outpatient” procedures, where you get to go home the same day that the surgery is done.
Above all, you don’t have to accept that your urinary problems are just part of getting older and you don’t have to be embarrassed by discussing these problems with your doctor!
