Is losing pee when sneezing normal? – GOOD SHAPE

No, under no circumstances is pee leaking unintentionally normal. But unfortunately, it’s very common: approximately 1 in 4 women will lose pee at some point in their life.

The loss of pee, in addition to being an extremely uncomfortable and vexing condition, can hide other problems such as injury to ligaments or fascia of the pelvis, changes in pelvic musculature and even be associated with genital prolapses such as fallen bladder or fallen uterus for example.

Therefore, it is extremely important that an accurate diagnosis be made of what is actually causing the loss of pee and that it be properly treated and monitored by specialized professionals.

A bladder that functions normally has the musculature relaxed in the filling phase to receive the urine that was produced by the kidney and functions as a reservoir; and the musculature of the urethra at this stage is contracted to close the exit channel, not letting the urine escape.

We also have a series of musculatures called the pelvic floor that also help with the closure of the urethra.

During a sneeze, for example, there is a reflex contraction of the pelvic floor musculature that helps with the closure of the urethra and contributes to the urine not escaping.

When the loss of pee happens in the sneeze it is very possible that the woman does not have this urethra closing mechanism working properly. there are several risk factors and it is usually their association that culminates in the loss of pee:

Increased pressure in the belly: This can generate weight overload on top of the bladder beyond what the pelvic floor musculature can handle; such as, for example, obesity, pregnancy, women with constipation, chronic cough and even women who do intense and high-impact exercises without having their pelvic floor previously prepared, such as crossfit for example.

Pelvic injuries: The most common is the one that happens in normal delivery, as some lacerations can compromise this bladder support. (regardless of whether you had an episiotomy or not, use of forceps or not, but the more vaginal injury you have, the greater the risk of urinary incontinence)

Collagen change: Some women already have a weaker connective tissue, these women in addition to urinary incontinence can have prolapses, hernia and usually have a mother or sisters with the same problem. Other women develop this tissue weakness from smoking or the lack of hormones that occur after menopause. Therefore, although incontinence is not exclusive to women after the age of 40, it is more common after this age.

Making an accurate diagnosis will guide the best treatment for each case, and many times it is necessary to combine therapies and a multidisciplinary team in the treatment. Some possible treatments:

Pelvic Floor Rehabilitation with specialized physiotherapist Use of local hormone Vaginal laser (CO2 laser, Erbuim laser, microfocused ultrasound and radiofrequency) Electromagnetic chair Surgery Lifestyle change: quitting smoking, weight control, balanced diet and well-oriented physical exercises and postural reeducation

Therefore, if you lose pee when you sneeze or if you know someone who is doing this, look for a Urogynecologist to investigate in your case what the cause is and the best treatment.