Question: “Are there ways to have more bladder control when I cough, sneeze or laugh? Eight times out of ten I experience leakage, and it’s really embarrassing.”
Answer from Dr. Daniel Gruber, urogynecologist from Sibley Memorial Hospital in Washington D.C., part of John Hopkins medicine.
There are two different types of incontinence. You are experiencing stress urinary incontinence. There’s also overactive bladder, or urgency incontinence, which is where you feel like you have to squeeze and run to the bathroom (and often don’t make it on time). Overactive bladder, or urgency, has a different type of treatment because the cause is different.
Your issue is more about stress incontinence with leakage from abdominal pressure such as coughing, laughing, sneezing, and exercise. As we mentioned in a previous answer, you can try doing Kegel exercises where you squeeze the pelvic floor for short and long holds, multiple times a day. Not everybody does these exercises correctly, so it’s important for you to get an exam while you’re squeezing so you can be assessed.
If you can’t squeeze your pelvic floor very well, then seeing a pelvic floor physical therapist is a good idea. A therapist can help train you to get those muscles coordinated and squeezing in a better fashion.
And like we covered before, a pessary is an option as well.
Finally, there are surgical treatments, typically a sling treatment, that are specifically for stress incontinence. Note that these sling treatments do not treat overactive bladder or urgency.