Stress Urinary Incontinence: How symptoms can be solved, help for women sufferers

PHILADELPHIA -- It's a common condition that's often stigmatized - stress urinary incontinence.

Many women hesitate at even mention it to their doctor. However, there are effective solutions.

It can happen with laughter, a cough, or heavy lifting - an embarrassing situation - bladder leakage.

Dr. Joshua Cohn of the Fox Chase Temple Urologic Institute says, it's very common in older women who've had multiple pregnancies.

"But it can exist in younger women to even in their teenage years, who have no history of pregnancy whatsoever," Dr. Cohn notes.

For them, high impact exercises can be a factor.

Dr. Cohn says the problem is weakness in the bladder neck.

"The urethra and the bladder neck don't close off, well enough to prevent leakage in the event of an increase in belly pressure," he explains.

He says some patients have both stress incontinence and overactive bladder.

"We'll recommend bladder testing to help distinguish between which one of those factors seems to be going on," he says.

Dr. Cohn says treatments range from monitoring the situation to surgery, depending why the bladder neck is weak, and how bothersome the problem is.

Physical therapy - learning exercises to strengthen the pelvic floor - is the least invasive.

"As many as four out of 10 patients get sufficient benefit with physical therapy, such that they don't need to pursue anything else," Dr. Cohn says.

In more severe cases, injections of a bulking gel can strengthen the bladder neck.

"The actual procedure itself in some settings can be done even in the office with a local anesthetic so no sedation needed," he says.

Slings that support the bladder neck are the most effective but also the most invasive.

Dr. Cohn says women troubled by stress incontinence should speak up.

"We can almost always be successful in making them better. And for many, we can be successful in making them almost all the way better, if not completely better," he says.

Dr. Cohn says extra weight also increases belly pressure, so keeping a healthy weight is important.