That ‘stress’ leak

Women often shy away from discussing incontinence issues. If you’re struggling with it, here’s how you can tackle it

The pelvic floor is the main muscle holding up the uterus, urinary bladder and rectum in females. (Representational Image | Pexels.com)

BENGALURU: If there is one topic on women’s health that is grossly ill understood by 90% of the population, it is Stress Urinary Incontinence (SUI). Is it because it is not life threatening? SUI is a type of urinary leak that is triggered by stress. The ‘stress’ that is referred is any chronic exertion or pressure on the pelvic floor. The pelvic floor is the main muscle holding up the uterus, urinary bladder and rectum in females.

Causes

• Chronic conditions like severe cough, constipation and obesity
• Weakness and injury to the pelvic floor due to traumatic childbirth, age-related weakness or genetic laxity of the pelvic floor muscles

Recognising it

• If you find an uncontrolled spurt of urine
• During physical workouts or while doing aerobics
• While having sex
• When coughing or lifting something off the floor
• In severe cases, by just changing your posture
   

Preventive measures

• Exercise regularly and maintain a healthy diet to keep your weight in check
• Treat the underlying conditions (like incessant cough and constipation) that cause the pressure on the pelvic floor
• Regularly do pelvic floor (Kegel’s) exercises

What are Kegel’s exercises

• Imagine you need to stop peeing mid-stream. The muscles you use then are the muscles you need to contract for pelvic floor exercises
• Contract the muscle and slowly start counting. Initially, hold for 5 counts and gradually, over the weeks, increase to 10 counts
• Relax for 3- 5 seconds
• Do 10-20 such repetitions, twice a day
• You will have to practice for 3 months at least, to determine if it’s helping you or not

Kegel exercises can be done anywhere and anytime. All you need to know is how to isolate the pelvic floor. Identify two times of the day when your routine is fixed and incorporate these exercises into those times. For example, while reading a book before bed, or cutting vegetables for lunch or watching TV in the evening, or even while travelling in a car.
Identify the pelvic floor muscle, in the first sitting, through a vaginal examination. Or, consult a physiotherapist who uses biofeedback therapy.

Precautions

1. Exercise on an empty bladder
2. Don’t hold your breath while exercising
3. Don’t overdo the repetitions or recommended frequency

Recommended surgeries:

1. Sling surgeries such as TVT (Tension free transvaginal tape), TOT (Tension Free Transobturator Tape), Autologous rectus fascia/fascia lata sling
2. Burch colposuspension.
   Both of them aim to correct the weakness in the pelvic floor muscle by narrowing the sub-urethral angle with mesh or sutures.

(The writer is senior consultant, obstetrics & uro gynaecology, Fortis La Femme Hospital, Richmond Road)