hgazette.com, Haverhill, MA

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July 25, 2013

Many suffer with incontinence, but help is available

Women affected most by stress incontinence

Editor’s note: The Gazette occasionally publishes columns written by local doctors. One appears here.

Millions of adults in the United States suffer with some form of urinary incontinence, but women suffer most from the type called stress incontinence, which causes urine to leak when they laugh, cough, sneeze or exercise.

It’s usually women over 40 who develop this condition because it is generally caused by childbirth, hysterectomy or menopause.

Incontinence of any type can cause emotional distress and depression, so it’s unfortunate that, due to embarrassment, up to 40 percent of women affected won’t seek medical help.

There is no need to feel embarrassed. Incontinence is a medical condition which with medical and/or surgical intervention, can generally be helped.

The muscles, ligaments, and skin in and around a woman’s vaginal tract act as a support structure to hold pelvic organs in place. Childbirth, hysterectomy and menopause can cause those support structures to weaken, resulting in a condition called pelvic organ prolapse. This means that the bladder, urethra, uterus, vagina, rectum, or small bowel have fallen out of their normal positions.

Without medical treatment or surgery, they can prolapse further, so it’s best to have a conversation with your doctor sooner rather than later.

Pelvic organ prolapse can cause discomfort and pressure, affect sexual function, and affect bodily functions such as urination and bowel function.

Types of pelvic organ prolapse include:

Prolapse of the bladder, which happens when the front wall of the vagina prolapses. The bladder may prolapse into the vagina which can cause the urethra to prolapse as well. Urine leakage during coughing, sneezing or exercise is a common symptom.

Prolapse of the rectum, which happens when the back wall of the vagina weakens and the rectal wall pushes against the vaginal wall, creating a bulge which may become noticeable during bowel movements.

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