Are little urine leaks a big problem? How to talk to your doctor

Your friend tells you a funny joke, and then it happens. You start pedaling during your spinning class, and it happens again. You hear water running and oops, you know you will also be wet. You might feel frustrated and embarrassed, but you are not alone. In fact, these types of urine leaks are quite common. Up to 50 percent of all women have occasional urine leaks and up to 10 percent have them frequently, according to the MedlinePlus Encyclopedia.

Leaking small amounts of urine when you do little things like laugh, sneeze or get up quickly are symptoms of stress urinary incontinence (SUI). What causes SUI? Leaks happen when the urethra, the tube that carries urine out of the body, doesn’t get enough support or isn’t able to close properly. Childbirth, injury to the urethra area, weak muscles, some medications, being overweight and surgery in the pelvic area are all things that can contribute to SUI. Women can experience SUI at any age starting in their 20s, with most common occurrences in women 30 or older. Incontinence is not a normal part of aging, so don’t assume that your condition just happens to “women my age.”

If you’re like most women who experience these little leaks, your first instinct will be to reach for a box of panty liners. When these unpredictable leaks continue to cause frustration or embarrassment, you owe it to yourself to talk to your doctor about the cause and treatment. Be the one to bring up this issue as many doctors will not ask you directly.

Here are some basic questions to help you discuss your symptoms at your next appointment.

1. Is it normal that I sometimes leak urine when I cough, sneeze, laugh or exercise?

2. What are the different kinds of incontinence? Which type do you think I have?

3. Are there any lifestyle or diet changes I can make to help my condition?

4. What are the medical treatment options? How long do these treatments take?

5. What are the success rates and risk factors of each treatment?

6. Will insurance cover the costs of incontinence treatment?

If you have SUI, your doctor will likely ask you to make some lifestyle changes including bladder training in which you gradually increase the length of time between bathroom visits. Pelvic floor exercises, commonly referred to as Kegel exercises, will help to strengthen the muscles that are used to control urine flow. Hormone therapy, such as estrogen creams, may also be effective in helping to improve pelvic floor muscle tone.

One common treatment for SUI is surgery to insert a mesh sling. A less invasive option for some women is a bulking agent like Macroplastique which is injected into the tissues around the urethra. Bulking agents are designed to allow the urethra to close more effectively and prevent urine from leaking. A urethral bulking procedure is performed in your doctor’s office or in an outpatient clinic or hospital in approximately 30 minutes. Health insurance usually covers this treatment. It is important to talk to your doctor about the side effects, risks and benefits of all treatment options and what you can do to make your treatment as effective as possible.

If you have SUI, it’s important to realize that it’s a common problem with many potential solutions. The first step is to talk with your doctor so you can continue to live life to the fullest each day.