Debbie GonzalezDoctor's Corner, Incontinence Leave a Comment

I'm having bladder leakage when I run and pads are uncomfortable. What options do I have?

Question: “I’m having bladder leakage when I run now. I tried pads but they are so uncomfortable. What other options do I have?”

Answer from Dr. Daniel Gruber, urogynecologist from Sibley Memorial Hospital in Washington D.C., part of John Hopkins medicine. 

Well, there are lots of different options. The first thing we always talk about is exercise. Kegel exercises can help somewhat, but not always completely. That’s because it’s very difficult when you’re running to contract your pelvic floor. If you’re about to sneeze or cough or laugh, then you can squeeze your pelvic floor at the same time and minimize the leakage. But when you’re running, it’s very difficult to squeeze with every single step.

A pessary can be used to help with this problem. A pessary is a silicone ring that goes under the urethra to help stop leakage. So as you cough, sneeze, or run, the urethra pushes up against it and it compresses it. 

A pessary is something that you can take in and out yourself, and you can use it as much or as little as you like. Usually an OB/GYN, but definitely a urogynecologist, can help fit these for you. Pessaries are a very good option if you’re not done with childbearing (because ideally, we don’t like to do surgery for women who still want to have children). 

The other option would be to do a sling procedure, in which permanent material typically goes underneath your urethra. In the same fashion as the pessary, it prevents or minimizes leaking while you’re running. These procedures are highly successful. They typically have over 90 percent success rates, and they have been done very widely around the world, for many, many years. There are some complications that can happen with it, but they’re typically quite low. Still, it’s important that you talk to your doctor about those complications.

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