Overheard at a party:
"Oh! God. Please dont make me laugh. Every time you tell a joke, I dribble.
Its so embarrassing!"
Patient to Doctor: "Doctor, please do
something about this cough. With every bout I dribble a few drops of urine and you know I
am a teacher!"
Dribbling of urine in women accompanying sudden increase in pressure
in the abdomen, i.e. during coughing, sneezing or even laughing loudly.
SIGNS & SYMPTOMS
Uncontrolled loss of urine with lifting, sneezing, singing, coughing,
laughing, crying or straining to pass stools.
WHY DOES IT OCCUR?
Shortening of the urethra and loss of the normal
muscular support for the bladder and floor of the pelvis. These changes occur during pregnancy and after childbirth,
particularly repeated childbirth. They may also occur as a natural consequence of aging.
WOMEN MORE AT RISK
- Repeated childbirth.
- Women over 50.
- Chronic cough or constipation.
HOW TO PREVENT
- Eat a normal, well-balanced diet and exercise
regularly to build and maintain muscle strength.
- Learn and practice specific exercises (see General Measures) after childbirth, before
symptoms of stress incontinence begin.
- Observation of symptoms.
- History and examination by a doctor.
- Urinalysis to establish whether symptoms are caused by urinary-tract infection or by
- Complete loss of urinary control. This requires surgery
- Recurrent Urinary-tract infections.
- Social isolation due to embarrassment.
If it is not severe enough to require surgery, exercise can improve the muscle function. If it is
severe, it can be cured with surgery.
Learn to recognize, control and develop the muscles of the pelvic
floor. These are the ones you use to interrupt urination in mid-stream. The following
exercises (Kegel exercises) strengthen these muscles so you can control or relax them
- To identify which muscles are involved, alternately start and stop urinating when using
- Practice tightening and releasing these muscles while sitting, standing, walking,
driving, watching TV or listening to music.
- Tighten the muscles a little at a time, "like squeezing a rubber ball with full
force and then releasing it very slowly."
- Tighten the muscles from front to back, including the anus, as in the previous exercise.
- Exercise 3 times a day, every morning, afternoon and evening. Start with 5 times each,
and gradually work up to 20 or 30 each time.
Medicine usually are not necessary for this disorder, but you may be
- Antibiotics if you have a complicating urinary-tract infection.
- A pessary made of rubber or other
material to fit inside the vagina to
support the uterus and lower muscular layer of the bladder.
Lose weight if you are obese.
CONTACT YOUR DOCTOR IMMEDIATELY
- You have typical symptoms of stress incontinence.
- Signs of infection like fever, pain on passing urine, frequent urination or a general
ill feeling develops.
- Symptoms don't improve after 3 months of exercises or symptoms become intolerable and
surgery is to be considered.