This sign gives special comfort to the millions of women with incontinence, uncontrollable leaking of urine. It’s kind of a hidden thing that people don’t want to talk about. It’s socially embarrassing for a lot of our patients at her clinic at Tufts Medical Center, Dr. Tanaz Ferzandi sees many women over the age of 40 with incontinence. But she also sees many younger women especially athletes and others who are physically active. You don’t need to quote suffer in silence Because it affects their quality of life. There are two major types of urinary incontinence. The first stress incontinence is the leakage of urine with activity like: exercise, laughing or even sneezing. I was in my early 60s But when I went like for a long walk or any kind of thing I could not hold it. It just kept coming out and coming out. For years, Rosemarie Lyons manage her incontinence by using sanitary pads. She eventually decided it was bad enough to talk to her doctor I go to work and have to change it two or three times a day You know what I mean. It was like a constant constant thing. I just couldn’t get away from it. Rosemarie had a sling procedure, an outpatient procedure where a thin synthetic tape or sling is inserted vaginally under the urethra to help support the base of the urethra and prevent leakage with certain activities. The sling is best used in women who have completed their childbearing. After placement, heavy lifting is not advised until the tissues have healed. The efficacy or cure rates are excellent for 85 to 95 percent. Patients are very happy. I was operated on outpatient on like a Wednesday and I was feeling good by the weekend. When I say feeling good. I had no pain, nothing. Another treatment for stress incontinence is a pessary; a ring-shaped device that’s inserted into the vagina for referral support. Some women can manage their own pessaries at home. While others come in every few months to the clinic to help them manage it. The other major type of incontinence is overactive bladder or OAB. Women with OAB have a sudden urge to urinate and may sometimes leak urine. They may also feel this urge frequently even when their bladder is not full. They get that sense of having to go to the bathroom but when that sensation occurs they need to go and sometimes they may not be able to contain that and they may actually have an accident trying to get to the bathroom. Treatment for Overactive bladder starts with a patient completing a three-day diary and measuring her avoided urine. Based on those diaries, we can talk to them about changing and modifying their behavior patterns, their fluid intake. A lot of people feel very worried that we’re gonna say, “oh you have to stop drinking” and in fact what we do is we encourage them to drink. But the right types of fluids and we moderate them during the day. Other treatments include physical therapy, medications and sacral nerve stimulation via interest in therapy. Particularly appropriate for those who also have fecal incontinence. A lot of my patients lovingly call it the “bladder pacemaker” because it indeed looks like a pacemaker. and what we do is we place it in the operating room under fluoroscopy, and we literally take this little electrode and stimulate the nerves, that we know feeds into the bladder. We’ve had some really good success with that as well. Another option: Botox injections. Yes, it’s the same kind of Botox the same family that you know people use for wrinkles But it goes in the bottom, and we do that with a tiny little camera and inject it in all these spots and if you think about what Botox does is it calms things down, it calms the wrinkles down, it smooths out muscles and the bladder is a muscle so by putting Botox into the bladder muscle it calms it down. Whatever the cause of incontinence, there is a way to treat it. The first step is talking to your doctor. For me, it was like a new lease on life Because I didn’t have to worry about going the bathroom. I’II tell everybody it’s unbelievable. I just can’t believe the difference.