Question

I have a leakage of urine when I sneeze, laugh or cough. It smells very bad. I've had two children. My stomach looks like I'm nine months pregnant and I now weigh almost 200 pounds, though the doctor said I don't eat enough to keep a bird alive. He did a thyroid test and said it was OK. Can you help me understand my weight gain and the odor? I'm so embarrassed.

Answer

From what you have described it seems that you have urinary incontinence. Simply, urinary incontinence is an inability to hold your urine until you get to the toilet. More than 13 million people in the United States - male and female, young and old -experience incontinence. It is often temporary, and it always results from an underlying medical condition.

Women experience incontinence twice as often as men. Pregnancy and childbirth, menopause, and the structure of the female urinary tract account for this difference.

Older women experience incontinence more often than younger women. But incontinence is not inevitable with age. Incontinence is treatable and often curable at all ages. You will need to overcome your embarrassment and see a doctor to learn if you need treatment for an underlying medical condition.

Physical changes that you may have resulting from pregnancy, childbirth, and early menopause along with being overweight can often cause stress incontinence. Anxiety is not a primary cause of urinary incontinence.

Types of Incontinence:

Stress: Leakage of small amounts of urine during physical movement (coughing, sneezing, exercising).

Urge: Leakage of large amounts of urine at unexpected times, including during sleep.

Functional: Untimely urination because of physical disability, external obstacles such as a 'tipped' uterus or fibroids. (Is your abdominal enlargement due to a cyst or fibroids, which might be contributing to your incontinence?)

Overflow: Unexpected leakage of small amounts of urine because of a full bladder.

Mixed: Usually the occurrence of stress and urge incontinence together.

Transient: Leakage that occurs temporarily because of a condition that will pass (infection, medication).

A thorough exam from your doctor will lead to a diagnosis; please remember that all cases of incontinence are treatable. Don't be embarrassed and see your physician.

Links

• Who develops incontinence, and why?