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Stress incontinence
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Stress incontinence

I've had what I think is stress incontinence, leaking urine with coughing, sneezing, heavy lifting.  I've been bothered with this for at least the last 3-4 years.  I've gotten into the habit of just crossing my legs and tightening muscles if I feel a sneeze/cough coming on, but sometimes leaking still happens.  Age is 52, not menopausal, weight about 185 pounds, 5'5".  I've never gone through childbirth nor had pelvic surgery so those muscles could not be weakened from those.  Could this be due to age and/or weight? My sister had multiple sclerosis and had the neurogenic bladder but I've never been diagnosed with that and have no neurologic problems except for sometimes tingling in feet that my PCP says is probably due to mild arthritis in my back.  I have an appt. with gyn. in Jan. to discuss stress incontinence and I want to be as well informed as I can so I know the right questions to ask her.  But this is just so embarrassing/shameful, I don't know if I can do this.  What tests can they do in the office to determine genuine stress incontinence?  Is there anything I could've have done in my past to have prevented this from happening?  Is surgery the only option for SI?  Is it common that self cath is necessary after TVT surgery or is that just coincidence if a patient has trouble voiding after surgery?  Can this get better or worse with menopause?  Thank you.
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Stress incontinence certainly is possible from the description.  

Office tests like obtaining a post-void residual, a urinalysis looking for infection, or urodynamic testing can all be considered.

Weight does have an association with the incidence of stress incontinence.

If there is a concern about MS, an MRI can be considered in conjunction with a neurologist.

There is no specific medication for the treatment of stress incontinence.  Weight loss, vaginal pessaries, and periurethral bulking agents can all be considered.  If these more conservative measures fail, surgery can be considered.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_
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