Uterine fibroids are common non-cancerous growths that develop in the uterus. These growths vary significantly in size, from tiny seedlings to large masses that can alter the uterus’s shape. While many individuals with fibroids experience no symptoms, these growths can sometimes lead to unexpected issues, including urine leakage.
How Fibroids Lead to Urine Leakage
Fibroids can cause urine leakage through mechanical pressure on the bladder. Large fibroids, particularly those on the front wall of the uterus (anterior fibroids), can press directly against the bladder, reducing its capacity. This pressure can lead to frequent and urgent urination. When the bladder’s storage volume is significantly diminished, even small amounts of urine can trigger involuntary leakage.
Fibroid position can also interfere with the bladder neck and urethra, which control urine flow. A fibroid near these structures might obstruct or distort them, making it difficult to fully empty the bladder or leading to stress incontinence. This type of leakage often occurs during activities that increase abdominal pressure, such as coughing, sneezing, laughing, or exercising. Subserosal fibroids, which grow on the outer surface of the uterus, or intramural fibroids, embedded within the uterine wall, can exert this pressure if large enough or strategically located.
Common Accompanying Fibroid Symptoms
Beyond urine leakage, uterine fibroids frequently cause other symptoms. Heavy menstrual bleeding, often characterized by prolonged periods or excessive blood loss, is common. This can sometimes lead to anemia due to iron depletion.
Many individuals also experience pelvic pressure or a feeling of fullness in the lower abdomen. This sensation arises from the physical presence of the fibroids, especially as they grow larger. Pressure can extend to other areas, causing backache or leg pain when fibroids press on nerves or muscles. Constipation may occur if fibroids exert pressure on the rectum. Some individuals also report pain during sexual intercourse, attributed to the fibroids’ size and location.
Approaches to Managing Fibroid-Related Leakage
Managing urine leakage associated with fibroids involves addressing both urinary symptoms and the underlying fibroids. Lifestyle adjustments can sometimes offer initial relief, such as bladder training to gradually increase the time between urination or careful fluid management to avoid excessive intake. Pelvic floor exercises (Kegel exercises) can also strengthen muscles supporting the bladder and urethra, improving urine flow control.
For more pronounced symptoms, non-surgical medical interventions can reduce fibroid size or manage symptoms. Medications, such as gonadotropin-releasing hormone (GnRH) agonists, can temporarily shrink fibroids by reducing estrogen levels, which may alleviate pressure on the bladder. Other hormonal therapies, such as progestin-releasing intrauterine devices (IUDs), can help manage heavy bleeding, indirectly improving pelvic comfort. Uterine artery embolization (UAE) is a procedure that blocks the blood supply to fibroids, causing them to shrink.
Surgical options are considered, especially when symptoms are severe or other treatments are ineffective. A myomectomy is a procedure that removes only the fibroids while preserving the uterus, which can relieve pressure-related symptoms like urine leakage. For extensive symptoms or when childbearing is not a concern, a hysterectomy (surgical removal of the uterus) provides a definitive solution by eliminating all fibroids. Consulting a healthcare professional is important to determine the most appropriate diagnostic and treatment strategy.