Do you leak when you laugh? You are not alone

It happens to many more women than you realize — you’ve taken pains to get dressed, feel great, and suddenly you cough, laugh, sneeze, lift something heavy, and find that you’ve wet your pants. Fear not. You are definitely not alone. According to the National Association for Incontinence, Stress urinary incontinence is the most common form of incontinence, affecting roughly 25 million women in the United States. Leakage for these women can occur with any physical activity that puts pressure (stress) on the bladder, and especially if the bladder is full. If it happens frequently, women can feel so embarrassed that they hesitate to engage in social activities.

Stress incontinence occurs when muscles and ligaments supporting the pelvic floor weaken. The most common cause is childbirth, during which tissue or nerve damage occurs during delivery. Other contributing factors are chronic coughing due to illness, obesity, smoking (which causes coughing), years of high impact activities such as running or jumping, age, and previous pelvic injury or surgery, such as having a hysterectomy. Fortunately, there are options for improving and treating stress incontinence.

Pelvic Floor Physical Therapy (PT). Pelvic Floor PT can help improve or alleviate stress incontinence by utilizing kegel exercises, electrical stimulation, and biofeedback. Some over the counter devices are available for PT at home.

Pessary. An incontinence pessary is an FDA-approved silicone or rubber device that is placed vaginally to support the urethra and bladder wall and help with leakage.

Over the Counter Device. They are similar to tampons, but instead of a wad of absorbent fibers, they are collapsible silicone structures with a non-absorbent polypropylene covering. Once inserted into the vagina, the support expands to lift and support the urethra to help stop leaks from coughing, sneezing, or exercising.

Surgical Options. 

1) Mid-urethral sling is a minimally invasive surgical procedure that treats urinary incontinence by placing a synthetic tape under the urethra to lift it back into a normal position. The sling is placed via vaginal approach and prevents urinary leakage by supporting the urethra during any physical activity.

2) Burch colposuspension surgery involves attaching the tissue near the urethra to the pectineal ligament (also called Cooper’s ligament) using sutures instead of synthetic tape. The procedure is performed laparoscopically, and requires placing tiny instruments through the belly.

3) Urethral bulking is another effective surgical treatment for stress incontinence, especially when incontinence is recurrent and related to weakness of the urethral sphincter muscle. This procedure can be performed very quickly in a physician’s office.

If you are experiencing stress incontinence, and would like to make an appointment to see Dr. Kirakosyan, call 716-656-4077, and visit

Dr. Armen Kirakosyan is a board-certified urogynecologist who uses the most advanced medical procedures and technologies in treating patients with stress urinary incontinence, urge incontinence, endometriosis, vaginal laxity, painful bladder syndrome, fecal incontinence, vaginal bulging, vaginal mesh pain and complications, overactive bladder, atrophic vagina sexual dysfunction, pelvic/vaginal pain, recurring urinary tract infections, and incomplete bladder emptying.


Printed in Buffalo Healthy Living Magazine 2022

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