Urine leakage was no laughing matter
Dear Dr Mitchell,
I had a very worrying incident the other day. I was laughing hard when I felt some urine leak out. I am just 38 years old, and mother of one teen child, and I had never had this problem before. What is happening with me, and what can I do to stop it?
The loss of urine that you experience with laughing excessively may be due to one of several factors. This may be a sign of urinary stress incontinence or may be due to an excessively over-distended bladder with overflow incontinence.
If your bladder is irritated from a urinary tract infection, then you can actually experience an involuntary loss of urine on laughing excessively. Childbirth can also sometimes cause damage to the pelvic floor, especially in situations where the baby is big, labour is prolonged or very rapid, and in situations where forceps or vacuum delivery is undertaken.
Damage to the muscles in the pelvic floor and weakness in these muscles that control the neck and base of the bladder can lead to urinary incontinence, especially in women who have had several babies delivered vaginally. Women who have diabetes mellitus for several years can also suffer from urinary incontinence as a result of damage to the nerves that supply the pelvic floor. This is usually seen in diabetics who have suffered from poor control of their diabetes over several years.
As you get older, the progressive decrease in your oestrogen levels that occur as a result of failure of your ovaries to produce eggs can result in weakness in the pelvic floor muscles and urinary incontinence . You are only 38 years old and have one child, so it is less likely that this is the underlying cause of your urinary incontinence. The reassuring thing is that it only happened once and might not be indicative of any significant underlying problem. If it recurs then you should get a urine culture done to rule out an underlying bladder infection and get a proper pelvic exam to rule out prolapse of your bladder.
Pelvic floor exercises, weight loss, avoiding chronic cough and chronic constipation can help to prevent damage to your pelvic floor muscles as you get older. Consult your doctor who will advise you further.
Best regards.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
DISCLAIMER:
The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.
