About one out of seven women experience urine leakage sometime during exercise. The usual culprit is known as stress incontinence, the kind that occurs when the muscles of the lower urinary tract are unable to control urine flow during times of increased abdominal pressure. That can happen from many physical activities, including laughing, coughing, sneezing and the impact caused by physical exercise.

"We tell women they need to exercise to be healthy, but some of them find urine leakage to be a barrier so they quit," says urogynecology and pelvic reconstructive surgery specialist Tomas Antonini, MD, Lone Star Urogynecology and Continence Center. "For many it depends on the severity of the problem. A recent study suggests that 85 percent of women with severe incontinence stop exercising or never start. If the problem is moderate, only 40 percent believe it is a barrier to working out and if the problem is mild, only 10 percent believe it has a negative impact."

He is hosting a seminar on the subject as part of the Ignite Women's Health series. Seton Medical Center Williamson is sponsoring Ignite Women's Health, a unique new fitness program as part of the celebration of the new hospital's opening. The program culminates on Feb. 2 with the Ignite 5K, a Williamson County-based race during SMCW's opening week.

Identifying the Problem

"The first thing to remember is that urine leakage is not normal," says Dr. Antonini. Someone experiencing symptoms such as frequent urination, a sense of urgency, the need to run to the bathroom and often not make it in time should consult a physician." He cites a study that estimates only about 35 percent of women with urination problems while exercising actually speak with a doctor about it.

For women, stress incontinence is the most common type of exercise incontinence. Several factors may contribute including multiple pregnancies and vaginal births, aging, smoking, obesity, certain medications and chronic cough such as with asthma or chronic bronchitis.

Unfortunately, the holding mechanism that is supposed to keep urine inside the bladder is overcome by pressure. We have to make it tighter. Sometimes that can be done through pelvic muscle rehabilitation or physical therapy for the pelvic floor muscles. If that is not effective, we can correct with minimally invasive surgery."

Treating Stress Incontinence

Dr. Antonini's specialty is a relatively new one that provides care for women with pelvic floor dysfunction. The most common of these problems includes incontinence and prolapse (dropped bladder, uterus or rectum). Although exercises and new medications work for some people, more are turning to surgery for a permanent fix, largely due to significant improvements both in the medical technology and the outcomes.

"If there is one thing I want women to come away with, it's that there have been dramatic changes in how this surgery works and how effective it is," continues Dr. Antonini. "Today, most surgeries are minimally invasive, done through small incisions. Some procedures are simple enough that they can be done in the office, although most are performed at an outpatient surgery center or hospital. Patients go home the same day, have minimal pain and the surgery is effective between 90 to 95 percent of the time."

The older methods required a large incision in the lower abdomen, a several-day hospital stay, resulted in significant pain during recovery and were effective only about 60 percent of the time.

"No matter what your age or physical condition, if you are suffering from incontinence, find out what can be done to help," urges Dr. Antonini. "You are not alone. An interesting study from Denmark that followed elite female athletes and professional ballet dancers found that 52 percent have experienced some incontinence during exercise."

Tomas Antonini, MD, FACOG
Urogynecology and Pelvic Reconstructive Surgery
Lone Star Urogynecology and Continence Center
(512) 716-0861