What can one normally be expected to do when they wish to pee but just can’t find a lavatory straight away? You’d expect them to hold it in, right? As per Healthline, a healthy bladder can hold nearly two cups of urine before the body creates a sense of urgency to pee.
Normally, an average person’s body takes about 9 to 10 hours before it produces two cups of urine. That does not mean you should wait too long each time to pee. Doing so frequently is unsafe and may cause complications like weakened pelvic floor muscles and pain.
Ideally, it’s good to empty your bladder every three to four hours. Now imagine if holding urine even for a couple of minutes was a near-impossibility. Yes, around 300 million people suffer from a loss of bladder control, commonly known as stress urinary incontinence (SUI).
That was the general worldwide statistic. In this article, we will exclusively focus on SUI among women. Let’s delve deeper into the symptoms, causes, and treatment options.
What Do the Statistics Say?
We already mentioned that about 5% of the world’s total population suffers from urinary incontinence, be it mild or severe. The National Institutes of Health (NIH) states that this condition is twice as prevalent among the fairer sex.
The census is mainly due to the way a woman’s reproductive system is designed. Events like pregnancy and menopause tend to affect the urethra, bladder, uterus, and bowels. In many cases, the muscles in the pelvic region weaken.
These muscles are responsible for supporting the organs of the nether region. When weakened, the urinary tract needs to work extra hard to hold the urine. It is the immense stress that leads to leakage issues.
Moreover, a woman’s urethra is shorter than a man’s. Hence, any damage to it will directly impact the function of the bladder. Though SUI can affect women of all ages, it is most common among seniors. Nearly 4 in every 10 women aged 65 and above develop SUI.
Symptoms of Urinary Incontinence and Causes
Now that we’ve seen the statistical data, let’s understand the common signs that accompany SUI. We will discuss the symptoms described by the Mayo Clinic. SUI is characterized by the leakage of urine. So, this is the primary symptom of the disorder.
When can this leakage happen? During moments the body undergoes extreme stress or sudden jolts. In other words, women may experience the symptoms of SUI during coughing, sneezing, exercising, bending over, walking too briskly, sexual intercourse, or laughing.
It’s important to remember that not every woman will showcase the disorder’s symptoms during all of the above-mentioned activities. Also, urine leakage may not occur each time one participates in the said activities. Whenever too much pressure is applied to the bladder, the symptoms appear, especially if one has not urinated for a couple of hours.
As for the causes, we have discussed them briefly in the previous section. Typically, SUI is a result of weakened pelvic floor muscles that support the urethra, bladder, etc. It may also occur when the urethral sphincter muscles are damaged. Let’s look at the events or conditions that can increase the risk of SUI –
- Menopause
- Childbirth, especially when it happens vaginally
- Any surgery performed on the pelvic region
- Menstruation issues
- Obesity
- Injury to the urethra
- Diabetes
Available Treatments and Prognosis
The most common question that women with SUI have is whether it can be cured. This is natural since it can be extremely nerve-wracking and challenging to live with this condition. When treated properly and on time, it’s possible to improve the patient’s quality of life.
A complete cure depends on factors like age, strength of pelvic floor muscles, and lifestyle changes. Let’s look at some of the most common treatments for this disorder.
Transvaginal Mesh
Most healthcare providers would first recommend this medical device to treat SUI. With the appearance of a net-like hammock, the transvaginal mesh is surgically implanted in a woman’s vagina. As per the American Urological Association, the vaginal mesh is the standard treatment for SUI which works even when other options have failed.
The device’s manufacturers claim that it can support the weakened pelvic floor muscles. It is not the effectiveness that is the problem. The transvaginal mesh has been severely criticized for causing major complications. According to TorHoerman Law, women have suffered from pain, unexpected infections, organ perforation, and vaginal scarring, among others.
By the end of 2023, over 100,000 injured women had filed a transvaginal mesh lawsuit against manufacturers like Ethicon, Boston Scientific, and C.R. Bard, among others. Though 95% of the cases have been settled, attorneys are still accepting new filings.
The Food and Drug Administration (FDA) has banned this device as a treatment option for pelvic organ prolapse. However, it remains available for SUI. Given the complications, it’s best to proceed with caution and look for alternatives.
Bladder Training
This procedure is a form of behavioral therapy that aims at strengthening the weakened muscles. A physical therapist may teach the woman how to train their bladder to reduce the frequency of nature’s call.
Does this treatment work? Yes, but it may take anywhere between a few weeks and a few months to notice a difference. Let’s look at some general tips for bladder training –
- It’s best to empty the bladder first thing in the morning, and again after breakfast.
- One must try to maintain regular intervals for urination throughout the day.
- The urge to visit the bathroom ‘just in case’ must be postponed.
- A fixed urination schedule must be followed during waking hours only.
Electrical Nerve Stimulation
This treatment method generally involves delivering mild electric currents or shocks to the patient’s pelvic muscles. The aim is to encourage nerve cell growth, strengthen the muscles, and improve communication pathways between the bladder and the brain.
The healthcare provider may also use the bladder nerve stimulator, which involves implanting the device under the skin of the patient’s lower back. It would then send electrical impulses to the sacral nerves responsible for bladder control.
This treatment is also effective but may include side effects like mild pain and bleeding due to needle insertion. The healthcare provider may recommend additional medicines to control the situation temporarily. In any case, results will only be visible after a few months. In some patients who are advanced in age, only symptoms can be managed.
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