Controlling A Hidden Problem

Stress urinary incontinence affects millions of Americans, including an estimated 35 percent of menopausal women, yet medical experts believe three-quarters of all sufferers don't seek help.

But in many cases, stress urinary incontinence is treatable. The Saturday Early Show's Dr. Mallika Marshall gave some advice that can help people with the disorder get back on track.

Stress urinary incontinence (SUI) occurs when a person loses control of his or her bladder during physical exertion. It can happen while coughing, sneezing, laughing, exercising, lifting a heavy object or during intercourse.

Marshall says embarrassment may be a reason many people with the disorder don't seek help. They don't feel comfortable talking about it, even with their doctor. Another problem, she explains, is lack of knowledge. Sufferers are unaware of the many treatment options and sometimes just accept it as a fact of life they have to deal with, which Marshall says it is most certainly is not.

SUI is most prominent in older women but younger women are not immune to it. There are some women in their 20s and 30s who have it. And this is especially troublesome for this age group because younger women tend to be more active and therefore more adversely affected by it.

The disorder is rare in men, but there are some who have it. They tend to be older and to have undergone radical prostate surgery.

The following are risk factors of SUI:

• Weak Pelvic Muscles
  
• Obesity
  
• Smoking
  
• Pelvic Surgery or Injury
  
• Estrogen Loss
  
• Medications

The most common cause of the disorder is weak pelvic muscles, a problem that can arise during pregnancy and childbirth. This is why some women experience temporary bouts of incontinence after having a child. It can also happen after surgery such as a hysterectomy. Estrogen loss, which happens to women as they go through menopause, can also lead to incontinence.

Smoking and obesity can also lead to stress urinary incontinence. Marshall says this is just another example of why it's important to lead a healthy lifestyle.

Marshall lists the following treatment options for SUI:

Exercise
This is the first line of defense against urinary stress disorder. Marshall says there is an exercise routine known as the Kegel Method that is beneficial to many women. These exercises help strengthen the muscles of the pelvic floor. Marshall says women, however, need to know that it may take some time for the effects of the exercise to kick in. The Kegel exercises can be done almost anytime or anywhere including at the office, in the car or while watching television.

Medical Devices
There are a number of medical devices available to women. Most of these devices are designed to support the bladder so a woman is less likely to have an accident when wearing one.

Medication
Some women find relief from a topical estrogen cream. Marshall says it is the loss of estrogen that is one of the risk factors for developing the disorder.

Surgery
Marshall says surgery is often very effective at immediately curbing the problem of incontinence. But as the years go by, some women find that the problem comes back. So before any woman undergoes this type of surgery she should be very aware that it may not be a permanent solution.

Duloxetine is a new drug for SUI waiting for approval from the FDA. In clinical studies, it has been shown to be very effective at helping with incontinence. It could be approved by the end of the year.