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Stress Urinary Incontinence: What to do Before Seeking Surgery

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Stress Urinary Incontinence: What to do Before Seeking Surgery

Many women develop stress urinary incontinence at some point in their life. This condition, in which urine leaks from the bladder during physical stress, has historically been associated with age. In truth, there are a handful of factors that contribute to this unwanted change in bladder control. When women come to our Palm Desert urology practice in search of answers for stress urinary incontinence, we often propose non-surgical modalities before suggesting surgery.

Our experienced urologists are well-trained to perform sling and bladder neck suspension procedures using the safest, most effective protocols. Though newer surgical techniques are less invasive, we recognize the value in avoiding the risks of bladder surgery whenever possible. Here, we discuss a few of the options women have for improving bladder control without surgery.

Managing Stress Urinary Incontinence with Lifestyle

Especially when SUI has just begun and is not significant, lifestyle choices may prevent worsening and even improve the current situation. Suggestions include:

  • Drink water throughout the day. Small “doses” of water rather than a full glass all at once allows the body to process fluids more slowly.
  • Schedule bathroom breaks. Urinating on a schedule can train the body to hold urine more efficiently, and also minimize bladder over-filling.
  • Notice foods and beverages that stimulate the bladder and avoid them. For example, spicy foods and caffeinated beverages are known to cause bladder irritation. Alcohol can also be a bladder stimulant.
  • If necessary, lose weight to reach healthy body mass index (the ratio of fat to muscle to skeletal structure).
  • Tailor physical activity to meet needs, such as taking a bike ride rather than a jog.

Addressing the Underlying Cause of Stress Urinary Incontinence

Many women have heard that they need to maintain the strength of their pelvic floor. Our mothers and grandmothers may have praised the efficacy of Kegel exercises. What is this really all about, and does it matter?

A strong pelvic floor matters. The pelvic floor is made up of muscles that support not only the bladder but the bowels and pelvic organs in general. These muscles are naturally weakened by pregnancy and childbirth, weight, and age. Heavy lifting, high-impact exercise, and straining to use the bathroom are also habits that can weaken the pelvic floor muscles. Stress urinary incontinence occurs when the urethra is no longer supported and it shifts out of place.

Pelvic floor strengthening may be achieved with Kegels or the use of vaginal weights such as Ben Wa balls or Kegel balls, or a small egg-shaped weight called a “yoni egg.” Another option that has recently become available is nonsurgical vaginal rejuvenation. These treatments take only a few minutes and work by heating the wall of the vaginal canal with radiofrequency energy. This stimulation increases collagen production that thickens the mucosa and improves muscle tone.

If nonsurgical therapies and lifestyle changes do not improve stress urinary incontinence and a woman does not intend to become pregnant in the future, a bladder sling or suspension procedure may be the next logical step in improving quality of life.

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