Urinary incontinence -- when you accidentally leak urine -- is a problem that affects millions of Americans, most of them women. There are several different types of urinary incontinence, with various causes and treatments.
With this type, urine leaks due to weakened pelvic floor muscles or weakened urethral sphincter. It can happen when pressure on your bladder increases -- such as when you exercise, jump, laugh, sneeze, or cough. Stress urinary incontinence affects 25-45% of women over the age of 30 to some degree.
Pregnancy and childbirth can stretch and weaken a woman’s pelvic floor muscles. Other things that can lead to stress incontinence are obesity or taking certain medications.
Urge incontinence is also called overactive bladder. With this type of incontinence, there is an urgent need to go to the bathroom and one may not get there in time. Causes of overactive bladder include bladder irritation, damage to bladder nerves, and other medical conditions that can affect nerves or muscles. These conditions include multiple sclerosis, Parkinson's disease, diabetes, and previous stroke. Bladder problems, such as infections (cystitis) and bladder stones, as well as certain medications, can also cause it.
This means that there is a component of both stress and urge urinary incontinence, which gives symptoms of both. Many women have both stress and urge incontinence.
Most women know about Kegel exercises if they have had a baby. They are often told by their ObGyn to perform these exercises for mild bladder leakage. These exercises are supposed to help to strengthen the pelvic floor muscles after childbirth. However, most women find it very difficult to know exactly what muscles they are contracting and whether they are performing them properly. In addition, Kegel exercises have to be performed on a routine schedule to have a benefit, which most women don’t perform with their busy lifestyles. Therefore, Kegel exercises have been shown to have minimal effect on bladder leakage.
For some women with more than mild or occasional urine leakage, some doctors may prescribe a device called a pessary. A pessary is inserted into the vagina and helps put mild pressure on the bladder neck, making urine leakage less likely. There are obvious reasons why women don’t want a pessary in their vagina at all times and many women stop using them.
Various filler substances can be injected to bulk up the urethral area. The concept is the same as with a pessary - the filler helps increase the resistance to urine flow, thus decreasing accidental urine leakage.
In more extreme cases of urinary incontinence, surgery is often offered. One procedure pulls the bladder back up to a more normal position, relieving the pressure and leakage. Another surgery involves securing the bladder with a "sling," a piece of material or mesh that holds the bladder up to prevent leakage.
Many women often ask if there is an alternative to a bladder sling for stress urinary incontinence (SUI). For severe SUI, surgery is probably the best options. However, with bladder sling failure rates over 20% and mesh complications, many women with mild to moderate urinary incontinence are looking for a non-surgical option.
One of the most common things that we hear in our office is when women discuss stress incontinence with their ObGyn and they are told that it is “just what happens after pregnancy” or “it’s your new norm”. Many women therefore give up on trying to improve their symptoms, unless they are so severe that they would resort to surgery. Most women don’t know that Viveve is a non-surgical treatment for stress urinary incontinence.
We specialize in non-surgical treatment of bladder leakage, specifically stress urinary incontinence. Viveve is a device that is inserted into the vagina and uses radiofrequency energy to gently heat the tissues of the vaginal wall and around the bladder neck. This causes formation of new collagen around the bladder neck and tightening of the pelvic floor muscles, thus decreasing urinary leakage.
In December 2018, Viveve released data from a 12-month study on stress urinary incontinence. It showed that 72% of women showed an improvement in urinary leakage and results lasted for over a year.
If you are having trouble with stress urinary incontinence and leak urine when performing everyday activities, call our office for a Viveve consultation at 203-374-0310. Our all-female treatment staff will assess you and perform your treatment in the privacy of our office.