Home' LOTL : August 2005 Contents 43
By Dr Ann
INTRIGUE & INCONTINENCE
QWhen I discovered my sister Martha Huber's diary the other day, I
noticed there were several entries about a small health problem
she seemed to have put up with for most of her life. She wrote
about the irritation caused her by dealing with stress incontinence, and as
I feel it is my duty to set everyone straight, so to speak, I think Martha
would appreciate my sharing her problem with your readers. I'd like
everyone to know how common it is and that there is treatment available.
Felicia Tillman, Wisteria Lane.
AYou are so civic-minded! I agree, this problem affects many women
and really should be talked about more. I'll attempt to explain for our
readers how stress incontinence arises and what can be done to
"Stress incontinence" is when you involuntarily pass a small amount of
urine due to physical activity (as opposed to "urge incontinence" when
you feel the need to go and cannot hang on until you reach the toilet). One
of the common causes of stress incontinence is something called urethral
hypermobility (your urethra being the tube that runs from your bladder to
your vulva). To understand this problem we need some essential facts
The bladder neck and beginning of the urethra are supported by the
vaginal wall and its attachment to the "levator ani" (anus lifter!) muscles.
These muscles form a funnel-shaped sling inside your pelvis called the
"pelvic floor". Your pelvic floor helps to resist increases in pressure inside
your abdomen -- i.e. when you sneeze, cough, lift something heavy.
Sometimes the main pelvic floor muscle, the pubococcygeus, can tear or
stretch during trauma such as childbirth and this alters the position of the
bladder and urethra. This, as well as other conditions where the front wall
of the vagina becomes lax (due to like aging and/or estrogen deficiency,
or pelvic surgery), can lead to urethral hypermobility.
The good news is that urethral hypermobility and stress incontinence can
often be treated with pelvic floor strengthening, medications, hormone
supplements and/or biofeedback techniques. Both doctors (and television
campaigns) suggest that strengthening your pelvic floor can improve your
control of urination. As seen on TV -- you can spend those boring minutes
at the autoteller, in the supermarket queue or at the bus stop practicing
your pelvic floor exercises and no-one will be any the wiser! Unless of
course you grunt with each effort -- this is unlikely as they are quite easy.
As a medical student I first heard how to strengthen your pelvic floor
muscles from a middle-aged gay male nurse who visited mothers in the
first weeks after giving birth to advise them on health and early childhood
issues. His description to me was to imagine while you were sitting on a
chair that there was a button beneath your labia (the outer lips of your
vagina). The exercise was to imagine gripping the button and lifting it off
the seat, scooping it upwards and inwards with your labia. Then relax and
let the button drop back down on the seat. Repeat 20 times. Grunting
optional (only if you want to draw attention to yourself).
But I must stress to everyone that incontinence is an issue that is best
explored in conjunction with your doctor. Each woman has individual
health factors that need to be taken into account when making a
diagnosis; your doctor needs to ascertain which kind of incontinence you
have and what treatment will be best for you.
Best of luck with the button lifting and thank you to Felicia -- always so
willing to share a secret.
Dr Ann is a doctor at a Sydney metropolitan area hospital. The opinions
expressed in this column are those of the author and are not intended as
a substitute for medical advice. If you have concerns about your health
please consult your health practitioner.
...for all your optical
needs, purple or otherwise.
Phone Sarah or Lizzie
for an appointment
on 9743 0898.
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PURPLE IS OUR FAVOURITE COLOUR!
As seen on TV -- you can spend those
boring minutes at the autoteller, in the
supermarket queue or at the bus stop
practicing your pelvic floor exercises and
no-one will be any the wiser!
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