Incontinence: Nothing to be pissed about

MANILA, Philippines - Have you ever experienced leaking urine? If you have, take heart — you are not alone. Many women around the world have complained of “going” at the wrong time, dealing with embarrassment and great inconvenience. In fact, one in three women will experience a sudden leakage of urine at one point in their lives, especially among those aged 35-65. Many of them are laughing, coughing, involved in physical activities or quietly doing their own thing when the accident happens.

Distressing as it is, involuntary urine leaks are a well-understood condition. Also called stress urinary incontinence, it happens when the pelvic floor muscle weakens. The pelvic floor is supposed to support the urethra, the tube where urine passes through. Normally, the pelvic floor keeps the urethra in place until the person urinates on purpose. When the pelvic floor muscle is weakened, however, the diaphragm’s movements can exert pressure on the bladder, causing the involuntary release of urine. This usually happens when a person laughs, sneezes, or does strenuous activities.

“Stress urinary incontinence should not be considered as a normal part of aging. It is actually preventable and can be treated,” says Dr. Jennifer Mari Jose, head of the Urogynecology and Incontinence Center at the Makati Medical Center, the first specialty clinic of its kind in the country.

Incontinence is also an occupational hazard. Many among the elderly have fractured their bones when they slipped as they rushed to the bathroom.

Despite the great inconvenience that it causes them, many women do not seek treatment for their condition. Many think they will be resigned to using adult diapers for the rest of their lives, not knowing that there are treatments for incontinence. “Being silent about this condition decreases our self-confidence and quality of life,” adds Dr. Jose. “The best thing to do is to consult your doctor.”

Dr. Jose had her fellowship training in urogynecology and pelvic reconstructive surgery at Mount Sinai Hospital, Toronto, Canada. She also trained in gynecologic laparoscopy at Chennai, India.

Women suffering from involuntary leaks should also see a urogynecologist. There are various treatment options available to them, including conservative and aggressive remedies. More conservative treatment includes behavioral and muscle therapy, including Kegel exercises. Drugs and medications, on the other hand, can also be used to bring down the activity of the bladder muscle, thereby avoiding leaks.

For those whose problems are not eased by such treatments, surgery is another option. Surgery for stress urinary incontinence is surprisingly easy, minimally invasive, and may be done on an outpatient basis. This is good news for 11-12 percent of Filipinas who are suffering from stress urinary incontinence and require surgery.

Among the hospitals that offer this treatment is the Makati Medical Center Urogynecology and Incontinence Center, which offers day surgery for the condition and has 90-percent success rate. The procedure can be done in 30 minutes, and requires just two 1-cm. incisions. The method involves placing a polypropylene-tape below the mid-urethra which, in turn, will support the urethra and return it to its normal position, preventing involuntary urine leaks. The patient, though, should refrain from vigorous physical activities until six weeks after the surgery.

For more information on interventions for stress urinary incontinence, call the Urogynecology and Incontinence Center in Makati Medical Center at 8888-999 local 7079.