The Tribune

By DR GREGGORY PINTO

It is the embarrassing secret sadly suffered in silence by thousands of Bahamian women: an uncontrollable loss of bladder control with urinary incontinence during sex.

As many as one in three women have some form of urinary incontinence, whether it be stress incontinence with urinary leak with every cough, sneeze, strain, or urge incontinence with urinary leak before making it to the bathroom, or both.

Urine leak during coitus/sexual intercourse can have a profoundly negative impact on a woman’s self-esteem and sexual health. The constant fear of leaking urine is a reality for thousands of Bahamian women, both young and older.

A history of a vaginal delivery, particularly a prolonged, complicated vaginal delivery, being overweight, nicotine smoking and advancing age puts a woman at greater risk for coital urinary incontinence.

Afflicted women often avoid sexual intimacy and rarely seek urological consult to solve the problem. But there is absolutely no need to suffer with this very common ailment in silence when confidential compassionate care is readily available.

Women do not have to endure anxiety and depression and a reduction in quality of life when female urinary incontinence can be effectively cured.

Evaluation of the cause of the urinary incontinence followed by behavioral strategies, medication, vaginal supportive pessaries, pelvic floor physiotherapy, or minimally invasive curative procedures can restore confidence and happiness and a satisfying and carefree sexual life.

Bahamian women do not need to avoid sexual intimacy for fear of urinary leaks.

Minimally invasive procedures such as outpatient vaginal sling placements, bladder Botox installations, sacral or posterior tibial nerve neuromodulation management, and laparoscopic pelvic organ prolapse surgery are all readily available locally in the Bahamas.

Bladder Botox aids in paralysing the bladder muscle and can significantly reduce both overactive bladder symptoms and urge urinary incontinence. The procedure is a painless, minimally invasive outpatient procedure that takes about 30 minutes and can provide relief for as long as one year at a time, without the need to take medications.

It is estimated that 24 to 66 percent of women with urinary incontinence report urinary leakage to varying degrees during sexual intercourse.

Bladder leak during sexual intimacy can occur during penetration, usually related stress urinary incontinence. Urinary coital leak can also happen during female orgasm and is often experienced by women who have urge urinary incontinence and overactive bladder symptoms.

Sexual life can severely be inhibited as well by overactive bladder syndrome with some women unfortunately having the severe urge to urinate as often as every fifteen to twenty minutes.

Lack of information regarding readily available curative management for coital urinary incontinence, in addition to unfortunate embarrassment, often cause thousands of Bahamian women not to visit an urologist for help.

Minimally invasive outpatient procedures if required can often be done on an extended lunch break with return to work post procedure.

Suffer no more. Restore your self-esteem and renew your happiness and confidence related to your sexual life. Break the silence. Seek compassionate, confidential care.

• Dr Greggory Pinto is a Bahamian urologist who has trained in South Africa, Germany, France and India. He is a member of the European Association of Urologists. Dr Pinto can be reached at Urology Care Bahamas at the Surgical Suite, Centreville Medical Centre, Collins Avenue and Sixth Terrace. Call 326 1929, e-mail welcome@urologycarebahamas.com, or visit www.urologycarebahamas.com.