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Treating Stress Urinary Incontinence

A Common Condition With Surprising Remedies

By Katherine Bontrager

n section to reduce their risk of incontinence later on. "The way you have your baby is tremendously important to your bladder control, pelvic and sexual function afterwards, and these issues have unfortunately been overlooked until now," he says. "Avoiding unnecessary procedures, learning the best pushing styles, understanding your risk for pelvic injury, these are factors that need to be discussed right alongside Lamaze breathing and prenatal vitamins."

Sometimes the onset of urinary incontinence cannot be helped, and if symptoms don't resolve by three to six months after childbirth, they're unlikely to disappear without some sort of treatment. Dr. Goldberg reports a wide array of options for sufferers, including Kegel exercises, lifestyle and dietary changes, physiotherapy and biofeedback, and office procedures such as collagen injections.

"For women past childbearing age who are seeking a more complete and lasting cure, remarkable new minimally invasive procedures such as the Gynecare 'TVT' can be performed in a 20-minute outpatient procedure, resulting in complete cures in over 90 percent of cases," Dr. Goldberg says. "The TVT has revolutionized the treatment of SUI, a major step forward from the more invasive surgical procedures of years past."

Another important change is found in drug manufacturing. In previous decades most medicine was not effective in countering incontinence (although drugs available do work on overactive bladders). According to Dr. Lind, this may be about to change. "One drug, Duloxetine, is not yet FDA approved but is expected to be approved in the near future," Dr. Lind says. "This will be the first FDA-approved drug for stress incontinence."

According to reports released by pharmaceutical companies Eli Lilly and Company and Boehringer Ingelheim Pharmaceuticals Inc., women who tried the drug (called Yentreve®) in clinical trials showed significant improvement in the frequency of SUI episodes.

Is there another solution? As with any muscle group, sometimes a little work out does wonders. "Pelvic strengthening (Kegel exercises) have been proven to decrease the chance of incontinence if performed during and after pregnancy," says Dr. Lind. "One-on-one teaching for pelvic strengthening, usually in an urogynecologist's office or at a dedicated physical therapist's, results in better results with pelvic strengthening."

Want to see more?

• Active Living: Managing Urinary Incontinence
• A Cure for Incontinence: One Woman's Story of Hope
• When Laughing Makes You Leak: Fast Facts About Stress Urinary Incontinence
• Pregnancy Today
• Talk about it!