Laugh, cough, sneeze -oh no!
Most people notice it when they cough, laugh or sneeze. Others have a need to "go," even after they’ve just gone to the bathroom. Some experience both symptoms.
Urinary incontinence (UI) affects over 13 million Americans – mostly women and commonly after childbirth. In fact, one in three women over the age of 60 is estimated to have bladder control problems.
The good news is that UI is treatable, and often curable. One person who is grateful for that is Kathryn Vittetoe of Lisbon.
"Over the past few years when I would cough or laugh, I would have a little leakage," she said. After some years, she decided to tell her family doctor who referred her to Steven Mindrup, MD, a urologist with Physicians’ Clinic of Iowa, P.C., who specializes in incontinence and pelvic floor reconstruction.
"It’s very common in both men and women," said Dr. Mindrup. "It occurs more often in women because of the incidence of vaginal childbirth."
According to Dr. Mindrup there are several kinds of UI. One of the most common is stress UI, due to poor support of the urethra and pelvic floor. It can also happen in men who have had prostate surgery.
Coughing, laughing, sneezing, exercising or other movements increase intra-abdominal pressure, thus putting pressure on the bladder and causing small amounts of urine to leak. Leading causes are physical changes from pregnancy, childbirth and menopause.
Dr. Mindrup first encourages patients to try conservative measures, such as eliminating irritants like coffee and other caffeine products. Another measure to try is the well-documented Kegel exercises to strengthen the pelvic floor muscles.
If surgery for stress UI is warranted, one highly-successful treatment for women is the sling procedure. In this procedure, a sling as wide as a piece of tape and consisting of a synthetic mesh material, is placed as a support under the urethra through one vaginal incision and two small abdominal incisions.
The best part of this procedure, which is 80 to 85 percent effective, is that it can be done as a same-day surgery. Patients are asked to refrain from lifting for four to six weeks, and report very minimal discomfort.
The other leading type of UI is urge incontinence caused by an overactive bladder. With this type of incontinence, patients may experience involuntary loss of urine while feeling a sudden need to urinate for no known reason.
Treatments include medications, biofeedback and even a pacemaker for the bladder. A treatment that is still in the experimental stage is Botox™ injections, which can help decrease the frequency of bladder contractions.
Dr. Mindrup points out that incontinence can also occur in special circumstances, such as stroke or spinal cord injury victims. But he admits that for many people, the cause is unknown. "We sometimes cannot find the cause," he said. Even so, treatment options are still available.
Vittetoe was found to be the perfect candidate for the sling procedure, performed at St. Luke’s Hospital.
"I wish I could express what a difference it makes," she said. "For anyone with my symptoms, I wouldn’t skip a beat in telling them to have the surgery."
She is grateful to Dr. Mindrup and his staff. "They are just super people, and that really makes a difference," said Vittetoe. "The nurse who tested me was such a jewel. I had an excellent experience."
Incontinence can be a very personal and potentially embarrassing problem that raises issues such as limited participation in activities and self-imposed isolation. Vittetoe learned it doesn’t have to be that way.
"It’s hard to admit you have a problem," said Vittetoe, who admits to being a very private person. "But I can’t say enough about that whole office. They were just very, very kind."
As for her procedure she reflects, "I’ve had a problem for over four years. But now, with the surgery, it’s given me total freedom. I’m constantly amazed."
Dr. Mindrup agrees. "Many of my patients say, ‘I wish I would have done that before.’ You’ve just got to be willing to ask the questions. Many of my patients are able to get back to exercising and their daily life after treatment."
That kind of success is a win-win for both Dr. Mindrup and his patients.
"Incontinence is a very common problem, and can be a very debilitating," he noted. "When you’ve helped someone make a change in their life that is so remarkable, it’s very satisfying."
To schedule an appointment with Midlife Care for Women call 319/368-5950.
