Can’t hold your pee? Don’t suffer in silence because of stigma’

Urinary Incontinence

(UI) affects 50% of adult women across the world. But the condition is grossly underdiagnosed in India owing to social stigma and shame. Dr Suresh Patankar, founder trustee of Urological Society, Pune chapter tells Steffy Thevar why UI is not just a minor inconvenience, but a health problem that can lead to a major lack of confidence in women

What are the initial symptoms of urinary incontinence?

It starts with the occasional few drops of uncontrolled urine discharge that keeps increasing gradually over weeks and months. One can leak urine while coughing, laughing, sneezing or during physical exertion (known as stress incontinence). Other symptoms include needing to urinate more often, a sudden, strong urge to urinate that’s difficult to control, and waking up multiple times during the night to urinate. If these symptoms persist or impact daily life, one must visit a doctor.

UI has been classified as a social disease by the World Health Organisation. How serious are UI’s effects if ignored long enough?

Prolonged exposure to urine can cause rashes, infections or sores, and even urinary tract infections owing to residual urine and continuous urinary soakage. It certainly affects the quality of life as the discomfort makes the person isolate herself from society and even close family members. The emotional distress of untreated bladder problems can lead to lifestyle changes, making people avoid activities they once enjoyed, potentially leading to depression or social anxiety. If ignored for long, such patients may also require psychiatric counselling.

Is every woman likely to face UI during pregnancy as well as postpartum?

No, not every pregnant woman will experience UI, but it is relatively common. Studies indicate that during the first three months postpartum,the pooled prevalence of any

postpartum incontinence

is 33%. The method of delivering the baby is also a determining factor in this. The prevalence of UI is higher in women who have had vaginal deliveries compared to those who have had C-sections. While UI is common during and after pregnancy, it is not universal, and various factors influence its occurrence. Proper care and rehabilitation before and after childbirth can help avoid chances of urinary incontinence.

Is UI becoming more prevalent in those under 40? What role does lifestyle play in this?

While it’s more common in older women going through menopause, and during pregnancy and childbirth, it’s getting more prevalent among women under 40 owing to several lifestyle factors such as obesity, an improper diet and lack of exercise. Smoking can weaken pelvic floor muscles, for instance, contributing to stress incontinence. Diabetes and other chronic medical conditions, as well as a family history of UI and stress also contribute. A history of heavy lifting, lack of or improper exercise can also cause stress incontinence. Modifying lifestyle can help reduce the risks and severity, especially among the young.

What goes by way of treatment?

Lifestyle modifications such as weight loss, quitting smoking, and dietary and lifestyle changes can help manage the condition.

Kegel exercises

(also called pelvic floor muscle training) are quite helpful, as is yoga. Medications or surgery are considered only when conservative measures fall short. It’s always best to consult a urology specialist for treatment.

BOX:

Kegels: The 60-second exercise that helps you fight incontinence

Kegel exercises help strengthen your pelvic floor muscles that support your bladder, bowel and vagina. These muscles hold your organs in place and assist with bodily functions like peeing, pooping and sex. Here is how to do them…

Steps for doing Kegels

Locate your pelvic floor muscles by lying flat on the floor with your knees bent
Draw your pelvic floor muscles up and in. (It should feel like holding the flow of pee and like you’re pulling your genitals up and in)
Tighten your pelvic floor muscles for 3 seconds. Then relax them for 3 seconds. This is one Kegel. Repeat this until you’ve done 10 kegels
Do Kegels once in the morning and once in the evening