SEXUAL HEALTH: A leaky bladder is not normal

A colleague was recently asked by his wife to buy sanitary pads and bring them home after work. The poor guy bought pads meant for women with a leaky bladder.

The wife was upset and as expected he had one of his worst nights this year. The following morning he knocked at my door to share the tale. This evoked memories of another case I dealt with a while ago at the sexology clinic when a leaky bladder wreaked

havoc in a marriage. I narrated the story to my colleague to help him understand that there were pads made for menses and pads made to catch urine when a woman suffers from incontinence.

So this young couple, Rose and James, had only been married for two years and they were already having sexual problems. When they came to the clinic, they had gone for three months without intimate contact.

They came to the clinic hoping I could help them bring back the passion to their bedroom. I set to work and did due diligence, first to try and unravel the mystery behind their tribulations and secondly to prescribe a lasting treatment.

I did a detailed sexual history including checking the experiences before the couple got married. I then examined each of them. It is important to note that some diseases present with symptoms of loss of libido and it was therefore important to establish that

there was no such underlying illness. I ordered for laboratory tests to complement all this. To the amazement of all of us, everything turned out normal. 

COULD IT BE WITCHCRAFT?

“The problem with you doctors is that you very quickly dismiss anything African,” said Rose interrupting my explanation when I delivered my verdict of normal results to them, “why are you not considering that this could be the result of witchcraft?”

She intimated that there were relatives working against them using witchcraft. Since there are no scientific criteria for diagnosing witchcraft, I brushed her sentiments aside and continued exploring other possibilities.

“Doctor, is there an alternative to pads?” James suddenly asked, “they are rather expensive and one has to use many in a day.”

On further enquiry, I found out that Rose had to constantly use pads because she had a leaky bladder. This was a problem she came into marriage with and it seemed to have gotten worse with time.

Initially James was tolerant but as they continued to live together, his body simply rejected Rose’s and this impacted negatively on their intimacy.

Lack of bladder control is referred to as urinary incontinence. There is stress incontinence whereby the urine leaks when you laugh, sneeze, cough, lift weights, walk up the stairs or exercise. These actions exert stress on the muscles of the abdomen and

tend to push out urine. If the muscles of the pelvic floor are weak, the person will not hold the urine and it just drips out. There is also urge incontinence which is also called an overactive bladder.

It happens when you are unable to control a full bladder. The urge to pass urine comes so fast and even if you run to the toilet the urine leaks before you get there.

Incontinence may be the result of a urinary tract infection, psychiatric problem, alcoholism or medicine being taken for other illnesses. Moreover, some incontinence may happen during pregnancy or after childbirth when the muscles are overstretched or injured.

“Well explained doctor, mine happens when I cough or climb stairs or other such activities,” said Rose anxiously, “is there treatment for it, I thought it was normal since I do not feel any pain and have used pads for a while now,” she revealed.

Urinary incontinence is treatable. Some cases require medicine, others surgery and others Kegel exercises of the pelvic floor muscles that control passage of urine. It is therefore very important that an accurate diagnosis of the cause is made.

From Rose’s assessment the problem was weakness of the pelvic floor muscles. The treatment was to exercise the pelvic floor muscles. I referred Jane to a physiotherapist to train her to do this.

FAVOURABLE REVIEW

Six months later, Rose could control her bladder and was no longer using pads.

“I must say the persistent smell of urine is no more, so now I can draw closer,” said a smiling James, when they came for a review.

The next stage of treatment was to take the couple through sex coaching. Once a couple has had intimacy problems and gone into a sexless marriage, intimacy does not return automatically after treating the cause of the problem.

A month of sex coaching brought back intimacy for Rose and James.

With that I warned my colleague to be sure to buy the right pads whenever his wife sends him. But even more important, do not allow the people you love to routinely use pads, if they leak urine they should seek medical help so that the cause is identified and treated.