July 18, 2011
SIU Physician Treats Bladder Control Problems in Women
Urinary incontinence or loss of bladder control is an embarrassing medical condition that affects millions of women in the U.S. It is very treatable but should be addressed early says Dr. Sohail Siddique, assistant professor of obstetrics and gynecology at Southern Illinois University School of Medicine in Springfield and a member of SIU HealthCare, the medical school’s practice group.
“About half of adult women have urinary leakage at one time or another. Although it is more common in older women, it also can affect younger women,” says Siddique. “Some avoid social activities because of incontinence or map out bathrooms when away from home.” Symptoms of urinary incontinence can range from mild leaking to uncontrollable wetting.
Many people are embarrassed to discuss their urinary incontinence with their physician, even though it is a common problem. “It often exists for years before a woman seeks help from a physician, and by that time it may be more advanced and difficult to control,” explains Siddique, who is chief of the urogynecology division in the department.
Two of the most common types are stress incontinence and urge incontinence. Stress incontinence occurs when urine leaks as pressure is put on the bladder with coughing, laughing, sneezing and other types of physical activity. Urge incontinence happens when individuals have a sudden need to urinate and aren’t able to hold it long enough to get to the restroom in time.
The primary risk factors for incontinence in women include older age, weight gain and number of pregnancies. The problem also can be brought on by urinary tract infections. Some medications can cause short-term bladder control problems.
“For treatment, we recommend women start with conservative steps such as pelvic exercises (known as Kegel exercises), physical therapy or biofeedback and weight loss,” says Siddique. Kegel exercises help strengthen the pelvic floor muscles. Siddique advises individuals to consult with their physician to learn how to do the exercises correctly, because they are effective only if done properly. Only half of women do them properly.
Lifestyle changes that might help include quitting smoking, avoiding alcohol, caffeine, and other bladder irritants, treating constipation and avoiding lifting heavy objects.
“Every treatment plan is geared for the specific type of incontinence that an individual may be experiencing. Some drugs can help the bladder empty more fully during urination, while other drugs tighten muscles and can lessen leakage,” says Siddique.
Another type of treatment is a pessary, which is a device placed into the vagina to help prevent leakage. Surgery such as a sling procedure or bladder neck suspension to repair faulty structures can be helpful.
Prolonged incontinence may put individuals at risk for getting rashes, sores, and skin infections. Siddique urges women who have the problem to seek treatment from their primary care physician or a urogynecologist or urologist early in the condition, so that treatment options can be considered and one’s quality of life can be improved.
For more information about urinary incontinence visit the American Urogynecology www.augs.org or American Urological Association www.auanet.org websites.
Siddique joined the SIU faculty in 2009. He completed a three-year fellowship in female pelvic medicine and reconstructive surgery at Johns Hopkins Medical Institutions in Baltimore (2005) and his obstetrics and gynecology residency at the Naval Medical Center in San Diego (2000). Siddique earned his medical degree at the University of Illinois College of Medicine (1994). He is board certified in obstetrics and gynecology and board eligible in female urology.