problems when laughing and coughing

[Guest Posts]

When I laugh or cough I tend to pee...is this normal? Is there anything I can do to stop this?

Maggie

[Mr Ased Ali]

It sounds like you might have stress urinary incontinence. This is a very common bladder problem for women. The pelvic floor supports the bladder and urethra (urine outlet). If this area gets stretched, weakened or damaged, then stress urinary incontinence can happen. Pregnancy and childbirth can cause this. Chronic coughing or nerve injuries to the lower back or pelvic surgery (can also weaken the muscles. The muscles also weaken with age. Typically there is leakage when coughing, sneezing, laughing, changing position or during some types of exercise.

The good news is that this can be managed in a variety of ways including:

Lifestyle changes: Quitting smoking, losing excess weight or treating a chronic cough will lessen your risk of stress incontinence and improve your symptoms. Sometimes changing your amount or pattern of fluid consumption may also help.

Pelvic floor muscle exercises: A physiotherapist can help you learn how to do exercises to strengthen your pelvic floor muscles and urinary sphincter. If you perform these exercises regularly, often it can resolve the problem completely.

Devices: There are certain devices designed for women to help control stress incontinence. These include specialized urinary incontinence pessaries which help support your bladder base to prevent urine leakage during activity, especially if your bladder has dropped (prolapsed). There are also urethral inserts which are tampon-like disposable devices inserted into the urethra (urine outlet) to prevent leakage. They are commonly used to prevent incontinence during a specific activity, but it may be worn up to 8-hours a day.

Surgery: There are various surgical procedures to treat stress incontinence in women, briefly, these are:
• A sling procedure - a piece of the woman's own muscle is used to create a sling or hammock that supports the urethra (urine outlet). (Previously, synthetic mesh was used as an alternative to muscle but this is no longer being used.)
• Injectable bulking agents – a gel like agent can be injected into tissues around the urethra. These materials bulk up the area around the urethra, making it close better.
• Retropubic colposuspension - This is a procedure that uses sutures to lift and support tissues at the neck of the bladder and upper portion of the urethra.

This is just a brief outline of the common options available. If you see a urologist, they will be able to give you much more information and guide you as to which is the best treatment option for you.