Tulane Center for Women's Health: The Bathroom Go-Go – LIVING WELL Magazine

The Bathroom Go-Go

By Sarah Balyeat, Tulane Center for Women’s Health, LIVING WELL Magazine

As women, we are constantly on the go. There are errands to run and friends and family to visit. But what happens when you constantly need to go – to the bathroom? Sometimes normal everyday activities like going to the grocery store, watching a movie or playing golf can become a hassle when you feel like you need to run to the bathroom all the time.

Not making it to the bathroom in time or leaking urine during activities like sneezing or exercising are both forms of urinary incontinence (UI). Many women think bladder problems are a normal part of aging and nothing can be done to help it. In fact, UI is NOT a normal part of aging and there are many treatment options available. The first step to treating UI is to talk to your doctor.

“Often, women don’t tell their doctors or loved ones about their incontinence problems because they think nothing can be done, or they are too embarrassed to talk about it,” says Tulane urogynecologist Dr. Margie Kahn. “There are actually different types of UI and many different treatment options,” says Dr. Kahn.

Stress incontinence occurs when a woman leaks urine during a physical activity like lifting, hitting a tennis ball, sneezing or coughing. It’s often a result of the pelvic floor muscles weakening which may cause the urethra and bladder neck to shift from their normal position. This prevents muscles that ordinarily keep the urethra shut from squeezing as tightly as they should, causing urine to leak into the urethra during physical activities that put pressure on the bladder.

Urge incontinence happens when a woman has a strong need to urinate and does not make it to the bathroom in time. This can happen when the bladder is only partially full and can be triggered from hearing or seeing running water, but sometimes there is no warning at all. Urge incontinence is one symptom of overactive bladder, a condition in which a woman feels she needs to use the bathroom frequently and urgently.

Many women experience symptoms of both stress incontinence and urge incontinence, a condition that is called mixed incontinence.

Treatment options depend on the type of UI and what a woman wants. “For some women, they want to be able to sit through a church service and others want to go to the grocery store without looking for the bathroom,” says Dr. Kahn. “Treatment options are different for each woman depending on what she wants out of the therapy.” Some treatment options include:

Noninvasive Treatment:

  • Physical therapy to strengthen the pelvic floor muscles (Kegel exercises).
  • Lifestyle and behavioral modifications such as diet changes.

Medication:

  • There are several medication options that can prevent unwanted bladder contractions, tighten the muscles of the bladder and urethra, or relax bladder muscles.

Devices:

  • Inserting a removable device called a pessary to support the urethra.

Interventional Therapy:

  • Botox injections to stop bladder spasms.
  • Injection of bulking agents around the urethra to keep the sphincter muscles closed.

Surgery:

  • Placing a sling made of synthetic mesh under the urethra.
  • Implanting a nerve stimulator to one of the sacral nerve roots to treat overactive bladder or urinary retention.

“Urinary incontinence occurs more often as we age, but it’s not a normal part of aging,” says Dr. Kahn. Many factors, including genetics, can be the cause of urinary incontinence. “It’s not something that only happens to women who have had children,” she says. “Even nuns can have UI.” Causes of UI can include:

  • Childbirth
  • Genetics (often runs in families)
  • Menopause
  • Obesity
  • Smoking

Urinary incontinence can be a very troublesome and embarrassing problem for women, but there are numerous treatment options available that range from non-invasive therapy to surgical intervention. Talking to a primary care physician or a urogynecologist is the first step to finding a treatment option. “I like to find out what a woman wants to do in her life that she isn’t doing now because of her urinary incontinence, and find a treatment option to meet her goals,” says Dr. Kahn.

For more information on the Female Urinary Incontinence Program at the Tulane Center for Women’s Health, call 504-988-8070.