Q: I am 19 weeks pregnant and have pelvic floor dysfunction. I am 22 years old. VERY YOUNG. The majority of the time when I laugh I urinate all over my pants. It is EXTREMELY embarrassing. I have had to hide this for most of my life now that I am pregnant I feel like if I have my child vaginally I will be incontinent for the rest of my life. I would honestly rather abort my child then be incontinent at 23 years old but I am too far along and that should NOT be a reason for a mother to have to abort her child. I am EXTREMELY worried about this issue and have no idea what to do. I have talked to a urologist about it in my state but they say there is really nothing that they can do while I am pregnant. PLEASE SOMEONE HELP!!!

Symptoms:  Incontinence, Pregnancy, Bladder problems

A:   Hello,
Thanks for contacting
Stress incontinence is sometimes seen in a pregnancy and can be worsened with the growing pregnancy in some women. At your young age , it is not seen quite often in primigravidas. You mention a classical symptom of incontinence while laughing or coughing or any increase in the intra-abdominal pressure. However it is advisable to differentiate between genuine stress incontinence, mixed incontinence or over active bladder with the help of urodynamic studies. You may choose to consult your physician and discuss the possibility and application of this investigation.

If its a genuine stress incontinence (GSUI)then even at 19weeks of pregnancy as of today, there is an option of getting yourself treated by a small vaginal surgery called TVT-O placement or Transvaginal tape-obturator urethral sling. This can be safely applied even during pregnancy and would not disturb or harm the pregnancy in any way. The only concern is during vaginal delivery. Some studies have shown that the tape doesn't stretch during the labour process and tend to cause obstructed labour and may break sometimes during parturition causing the return of the symptoms. So in such cases , elective cesarean section may be offered without disturbing the sling . This TVT-O technique is simple and safe and you may discuss the possibilities of the same with your treating physician. I am sure you don't have to go through this ordeal when medical and surgical options are available for treatment.

I hope i have answered your query in detail and provided solution for your concern.
Wishing you best of health,

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