You just had a baby and life is great. Then, you laugh a little too hard or go for your first jog post baby and you notice it - leakage. Take a deep breath and don't freak out. Post-partum urinary incontinence is actually a common issue affecting millions of women. It can adversely affect quality of life and, for many women, can be an embarrassing issue to address. Fortunately, there are many highly effective treatments for incontinence.

First, you and your physician must determine what type of incontinence you are suffering from. The treatments will vary based on incontinence type. Classically after vaginal deliveries, women tend to suffer from stress urinary incontinence. This type of incontinence occurs when urine leaks while laughing, coughing, sneezing, or anything that may put abdominal pressure on the bladder. When pelvic muscles stretch with pregnancy and delivery, the bladder and urethra may lose some of the support that aide in continence mechanisms. Kegel exercises may help in building up the failing pelvic floor muscles, but often this is not enough. Losing any excessive weight helps take pressure off the bladder and can significantly decrease incontinence episodes. For some women, a surgical procedure to boost the support under the urethra is in order, utilizing a mid-urethral sling.

​For women who tend to leak with the sudden, uncontrollable urge to urinate, medication are highly effective in relaxing the bladder. This condition is referred to as urge urinary incontinence, or overactive bladder. For severe cases or for patients who do not tolerate medications, there are other options available that are effective. Posterior Tibial Nerve Stimulation is a treatment where a tiny needle is placed in the ankle to stimulate the posterior tibial nerve. This nerve enters the spinal cord at the level of bladder nerves that send urgency signals to the brain. After 12 weekly treatments, lasting 20 minutes each, many patients experience for overactive bladder. Botox is injected into various parts of the back of the bladder and can help alleviate urgency symptoms. The effects typically last six months before a patient needs retreatment.

It is possible to have mixed urinary incontinence - both stress and urgency incontinence. It is especially important for you and your doctor to carefully discuss symptoms to determine what component is most bothersome so you can receive the most effective treatments for your needs.

 

Daniel Mannas, MD Dr. Daniel Mannas received his Doctor of Medicine from the University of Oklahoma Health Sciences Center in Oklahoma City and completed his residency in Urology at the University of New Mexico in Albuquerque.