Millions of women across the globe are facing a common problem, the Stress Urinary Incontinence (SUI), but only a handful can get rid of the embarrassment and consult physicians. Joyati Sinha (name changed), a top-notch senior executive with a leading corporate house, did the same when she confronted a similar situation while on a business meet. As she coughed, she had a leak from her uterus. “For a few days, I kept the matter to myself, not knowing who to talk to. I didn’t consult a doctor out of reluctance and embarrassment. I hoped that the issue will get resolved on its own. However, when the problem persisted, I spoke to my gynaecologist,” she says. And then it was found that Joyati suffers from the SUI. She is now getting herself treated.
Also known as ‘effort incontinence,’ the SUI is the unintentional loss of urine. It is essentially due to insufficient strength of the pelvic floor muscles and is provoked by a physical movement or activity—coughing, sneezing or exercising—that puts pressure (stress) on the bladder. “It almost always results from an underlying treatable medical condition, but is under-reported,” says Dr Atul Peters, Director, Bariatric, Metabolic and Minimal Access Surgery, Fortis. “Being overweight can increase your chances of experiencing SUI due to accumulation of extra weight in the midsection. When you carry excess weight in your abdominal area, the extra kilos put added pressure on your bladder. The extra pressure makes your bladder more likely to leak,” he adds.
Bladder symptoms affect women of all ages. However, bladder problems are prevalent among the older and obese women more than others. “Up to 35 per cent of the total population above the age of 60 is estimated to be incontinent, with women twice as likely as men to experience incontinence. Stress incontinence occurs because of poor function in the muscles that support the bladder or control the release of urine,” explains Peters. “Sometimes both the muscle groups are involved. The bladder expands as it fills with urine, but the valve-like muscles at each end of the urethra, which is the short tube through which urine flows to exit your body, normally stay closed, or contracted, thus preventing urine release until you reach the bathroom. When the muscles supporting the bladder are weak, pressure can trigger urine release before you’re ready. Problems with the valves themselves (the urinary sphincters) may have the same effect.” Even though the problem is very rampant, it is curable. “‘I am ashamed to talk about it,’ is what I hear each day from my patients in my bariatric practice. There is a list of treatment options, ranging from conservative treatment, behaviour management, bladder retraining, pelvic floor therapy, medications and surgery. One of the most common treatment recommendations is exercising the muscles of the pelvis. Kegel Exercises may strengthen a portion of the affected area. Patients younger than 60 years benefit the most. The patient should do at least 24 contractions daily for at least six weeks,” Peters suggests.