Pelvic floor and sneezing

Dr Mark Porter / 02 August 2017

Dr Mark Porter advises a woman who finds sneezing and laughing causes an embarrassing problem.

Q: Every time I sneeze or laugh I wet myself slightly.  I am embarrassed to say that it has been going on for years having started after the birth of my last child (I am now 58). Have I left it too late?

A: It is never too late to seek help, but early intervention is best. At least three million women in the UK have some sort of continence problem and stress incontinence – leakage of urine on exertion or when coughing, sneezing and laughing – is by far the most common complaint. The majority of those I see with stress incontinence are in their thirties and forties and not, as is widely believed, collecting their pensions.

Having children is the biggest cause of stress incontinence and as many as 1 in 3 women will suffer to some degree - albeit temporarily in most cases - as the tissues and muscles in their pelvis take time to recover during the first few months after birth. But it’s not just the passage of the baby that weakens tissues in the pelvis – stress incontinence is also more common in women who have had caesareans, suggesting it is as much related to pregnancy as it is to childbirth.

Fortunately, there has never been a better time to seek help thanks to a national network of continence services, often run in the community by dedicated nurse specialists.

Your GP should be your first port of call – he or she will know what services are available locally and refer accordingly. Step two normally involves an assessment or your problem based on your symptoms, a physical examination and special tests (urodynamics) if required – there are other types of incontinence that require different approaches and differentiation is important if treatment is to be successful.

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