Vera Asis’ first pregnancy in 1997 was difficult.


She spent 24 hours in labor before her first child was delivered after an emergency Caesarean section.

After that she began dealing with incontinence.

“When I sneezed or when I coughed there was some leakage,” Asis said. “I would urinate frequently.”

Child bearing is one of the most frequent causes of incontinence, said Chandra Adams, an obstetrician-gynecologist with Full Circle Women’s Care, where Asis has worked as office manager for the last three years.

Other causes can be a loss of estrogen and other hormones and menopause. The aging process can also lead to incontinence.

“As you get older, your pelvic floor muscle weakens,” Adams said.

It’s a problem that’s a lot more common than people used to think, said Gail Page, co-founder and board chair of Consortia, a health care services company that has created an innovative program to help women with incontinence.

Women of her mother’s generation didn’t like to talk about the problem so it went under-reported, said Page, who believes that about 50 percent of women develop some form of incontinence.

With four million babies born each year and with the post-World War II baby boom generation now ranging in age from their late 50s to their early 70s, the number of women dealing with incontinence is only growing, Page said.

For women who are incontinent a cough, a sneeze, a laugh or a jump can cause leakage, Adams said.

“Women who leak, they have depression, they stop having sex,” said Page. “It’s really sad … I had the problem. I’d sneeze, I’d leak.”

Consortia partners with physicians like Adams to help with diagnosis, therapy and education for women with incontinence, providing a program that uses a combination of electromyography to analyze the problem and electrical stimulation to strengthen the pelvic floor, the big band of muscles that hold the bladder in place.

When women report the problem to her, Adams must first rule out a urinary tract infection, which could be the cause. Then she performs a pelvic ultrasound examination to make sure the problem isn’t “something pressing on the bladder,” which would probably require surgery.

If neither an infection or a growth is responsible, the best approach is Consortia’s “pelvic floor rehab program” plus a program of Kegel exercises designed to strengthen the muscles of the pelvic floor.

Asis, who has been dealing with the issue for two decades, began doing Kegel exercises at the recommendation of a urologist she saw. But she learned during her recent eight week course of treatment that she had been doing them wrong for years.

“Even after the first couple of treatments, I saw the differences,” Asis said. “Now I feel almost 100 percent back to normal.”

Charlie Patton: (904) 359-4413