Urinary incontinence is actually caused by the weakening of the pelvic floor muscles due to childbirth, loss of pelvic muscle tone, or gynecological surgery. The muscles of the pelvic floor support the organs of the lower urinary tract, keeping the urethra in position until it is time to urinate. A weak pelvic floor muscle cannot hold the urethra in its correct position, that’s why any movement from the diaphragm that puts pressure on the bladder may cause urine leakage.

Stress urinary incontinence (SUI) is the most common type of involuntary urine loss that involves the leakage of urine during exercise, coughing, sneezing, laughing, lifting heavy objects, or other body movements that put pressure on the bladder.

Having said that, incontinence does not only hinder physical activities, it may also cause psychological stress because of embarrassment. Fortunately, incontinence is not something women have to endure.

However, women who suffer from incontinence do not really intend not to seek medical help. More often than not, they are not aware that it can be treated.

To give Filipinos sufficient information about incontinence, Dr. Harold Drutz, director of the American Urogynecological Society and one of the foremost urogynecologists of Canada took part in the recent Dr. Constantino P. Manahan Memorial Lecture entitled "A Historical Review of Surgery of the Pelvic Floor: Where Have We Come From and Where are We Going" at the Makati Medical Center.

Dr. Drutz imparted important information on how incontinence can be treated, "The cost of curing incontinence depends on the severity of the patients’ condition. The doctor needs to review the case and consider first conservative treatments such as drug therapy, behavior modification, Kegel exercises, and surgery. However, 11 to 12 percent of the women who experience SUI would require surgery."

According to Dr. Drutz, surgery with the use of a tension-free vaginal tape brings back the descended urethra back to its normal position. The tape is placed below the mid-urethra, and it passes through several tissue layers, which naturally secures the tape in place.

Here in the Philippines, the Makati Medical Center’s Urogyne and Incontinence Center offers a day surgery that can rid of urine leaks fast, through the use of a tension-free vaginal tape (TVT).

"The method involves the placing of a repair tape below the mid-urethra which will, in turn, support the urethra and return it to its normal position, preventing involuntary leaks. The surgery, with a success rate of 90 percent, can be completed in a matter of only 30 minutes," explains Dr. Jennifer Jose, co-head of the Makati Medical Center’s Urogyne and Incontinence Center.

The procedure is minimally invasive and requires very little incision (two 1-cm incisions); this can be completed by the surgeon in 30 minutes with the use of regional or general anesthesia. The TVT works by gently supporting the mid-urethra and returning it to its natural position, preventing the involuntary loss of urine. At rest, this support is tension-free, but during effort or stress, it provides effective urethra closure. Patients are encouraged to avoid the use of tampons and participation in sexual intercourse for six weeks.

"The patient needs to be aware of the facts and risks that go with the treatment because no operation can guarantee 100 percent recovery rate; however, there is a 5 to 10 years follow-up and an 80 percent success rate," says Dr. Drutz.

He continues: "Undergoing the procedure will definitely improve the patient’s quality of life; usage of protective garments such as adult diapers is a never-ending treatment, which will eventually get more costly in the long run."

(For more information, visit the Urogyne and Incontinence Center at the Makati Medical Center, Makati City.)