Urinary stress incontinence is a common affliction of women after age of 40. The cause is usually related to childbirth injuries that may not have been recognized at the time, and developed slowly over the years. Treatments, by means of physical therapy, medication, or minor surgical procedures depend on the specific type and severity of urinary loss.
Commonly, urinary tract, or bladder, infections will cause frequency, and burning upon urination. A sample of urine, collected in a special sterile container, and sent to the laboratory will confirm this diagnosis and help to identify the offending bacteria, and an antibiotic to which the bacteria is sensitive. A few days of the proper antibiotic will relieve this condition and its unpleasant symptoms.
If a bacterial infection is not identified and symptoms of urinary urgency, frequency, and occasional loss of urine with bladder spasm may require medication that will relieve symptoms of bladder spasms.
Urinary stress incontinence, with involuntary loss of urine with coughing, sneezing, laughing, changing body positions, or sometimes during orgasm, may occur in all ages of women, but more commonly in women with a history of vaginal deliveries. In these women, often as a result of childbirth injuries, the normal supports of the bladder and the urethra, the tube leading from the bladder to the outside, looses some of its support and the normal sphincter muscles that surround the urethra may not be able to clamp the urethra shut in a sufficiently effective manner. Among the variety of techniques, we favor the insertion of a thin , light piece of mesh to help support the critical area where the urethra emerges or joins the bladder. There is a variety of other techniques available, (1), lifting of the bladder at the time of an abdominal operation, (2) placement of elevating sutures by means of a small horizontal “Bikini” incision just above the pubic bone, and lastly, (3) insertion of a small vinyl sling placed underneath the urethra through a small incision inside the vagina.
Convalescence takes several weeks until healing is complete, but normal activities may be resumed after 2 days, with sex a month later.
