Bladder Leak

Bladder leak is a very common problem in women, especially from the postmenopausal stage.

In many cases, it is an embarrassing situation for patients who feel some shame when it comes to admitting the problem. In others, it is considered as physiological and within normal in the transition to the menopausal stage. Therefore it is a pathology, underdiagnosed, undervalued and undertreated and that can very importantly alter the quality of life of the person affects.

It is defined as the patient’s manifestation of involuntary urine loss.

The most common types of UI in gynecological consultation are:

Bladder leak: Involuntary loss of urine that coincides with increased abdominal pressure triggered by physical activity
Urgent-overactive bladder urinary incontinence: involuntary loss of urine associated with a strong desire to urinate (urgency). It is usually accompanied by an increase in day and night time
Mixed urinary incontinence: association of symptoms of exertion and urinary urgency
The prevalence of this often underdiagnosed pathology is 30-40% between the ages of 50 and 70. Under the age of 50, it is much less common, around 10%.

There are a number of well-established risk factors for the UI:

Vaginal delivery. The number of births. Duration thereof. Weight of newborns
Age, by wear and tear of the tissues.
Obesity or overweight
Occupational factors (jobs involving large physical efforts, impact sports)
Chronic respiratory diseases
Taking certain medications: antihypertensives, diuretics, antidepressants
Pelvic organ prolapse
Family history, genetic factors
The diagnosis is based on anamnesis or cynical history and a detailed physical examination. With these two tools we must achieve the following objectives:

Objectizing and quantifying urine loss
Check for predisposing factors
Assess the impact on the quality of life
Rule out gynecological or urological pathology associated
Decide on complementary studies
Consider the most timely treatment
Measures or treatments to minimize or correct symptomatology include:

Promote balanced diets as overweight has been shown to be an independent risk factor for incontinence.

Avoid drinking and enriching bladder irritating foods and beverages that contain gas, caffeine, theine, chocolate, and spicy foods
There are foods that increase urine production such as watermelon, melon, salads, espárragos….De equally alcohol also has a diuretic effect
Reeducation or bladder training. Avoiding poor urinary habits
Physiotherapy. Pelvic floor exercises, Kegel exercises, can improve IU by up to 60%.
Pharmacological treatment for emergency IU. They are chronic treatments, usually one tablet per day, with an efficiency between 40-60%.
Treatment of urogenital atrophy with vaginal gels with estrogen.
Surgical treatment of stress IU with tension-free suburethral meshes with one very high quality of life improvement and healing rates, 85-90%.
The final conclusion is that this is a very common pathology and that although it may be uncomfortable to expose we should consult with our gynecologist at the onset of symptoms since in a high percentage of patients we can improve quality of life.