Women’s bodies are miraculous. Women bear and feed children, take care of household chores and work obligations while dealing with painful menstruation, and throughout life, undergo a variety of changes that put you under intense pressure and stress. You are often told that some of these things are unavoidable. While that may be true, there are other conditions that are avoidable and when they do occur, should be diagnosed and treated properly and promptly. For many women, one of the most common and frustrating changes your body faces is a new inability to control your bladder the way you once could. You go to your healthcare provider for a diagnosis and treatment, but instead they misdiagnose you or fail to give you the proper treatment. Now, not only are you still dealing with it, but things might even be worse. If your female urinary incontinence was negligently treated by your doctor or another healthcare provider, an experienced New Mexico medical negligence attorney with Erin Marshall Law may be able to assist you in filing a claim and recovering the compensation you deserve under the law. Call (505) 218-9949 to book your consultation in our Albuquerque office and learn more about your legal rights and options.
Female Urinary Incontinence: Types, Causes, and Risk Factors
Female urinary incontinence is a loss of bladder control and can range in severity from occasional leaks when the individual coughs or sneezes to an urge so strong and sudden that they cannot get to the toilet in time. Urinary incontinence tends to occur more often as people get older. There are different types of incontinence, as well as a variety of causes and risk factors.
Types of Incontinence
The Mayo Clinic describes five types of urinary incontinence. Understanding the different types and being properly diagnosed with the correct one is vital to proper treatment of female urinary incontinence.
The five types are:
- Stress: This is when urine leaks are caused by pressure on the bladder when the individual coughs, sneezes, laughs, exercises, or lifts something heavy.
- Urge: An individual feels sudden, intense urges to urinate and before they can do so, they involuntarily urinate. This type of incontinence may be caused by a minor condition like an infection or a more severe condition like diabetes or neurological disorder. People with urge incontinence often have to urinate more often, including while trying to sleep at night.
- Overflow: This is when the bladder does not fully empty and the individual experiences frequent or constant dribbling of urine.
- Functional: This type of incontinence is unique in that the bladder and its nerves function normally, and the incontinence is caused by another physical or mental impairment that prevents the individual from making it to the toilet in time. For example, someone with arthritis may suffer from functional incontinence if the arthritis prevents them from being able to unbutton their pants in time to use the toilet.
- Mixed: This occurs when the individual experiences more than one type of incontinence. Most often, it refers to a combination of stress and urge incontinence, but it can refer to any combination of two or more types.
Incontinence Causes
Female urinary incontinence can be either temporary or permanent. Temporary incontinence may be caused by factors such as caffeine, alcohol, chocolate, artificial sweeteners, chili peppers, large doses of Vitamin C, or spicy, sugary, or acidic foods. Blood pressure and heart medications, stimulants, muscle relaxants, urinary tract infections, and constipation can all also cause temporary urine leaks.
Persistent or chronic incontinence may be caused by:
- Pregnancy: Hormonal changes and the added weight from the fetus can put pressure on the bladder and cause stress incontinence.
- Childbirth: Vaginal deliveries can weaken the muscles that control the bladder and damage the bladder’s nerves and supportive tissue. This can lead to a prolapsed (dropped) pelvic floor, when the bladder, uterus, small intestine, or rectum protrudes into the vagina and may cause incontinence.
- Menopause: Estrogen plays a role in keeping the bladder lining and urethra healthy. Women’s estrogen production drops after menopause, which can cause deterioration of those tissues, leading to incontinence.
- Age-related Changes: Like the rest of the body, the bladder muscle ages. As it does, it can decrease the bladder’s ability to store urine. Additionally, involuntary bladder contractions become more frequent as people age.
- Neurological Disorders: Parkinson’s disease, multiple sclerosis, spinal cord injuries, brain tumors, or strokes can all interfere with the nerve signals involved in bladder control, causing incontinence.
- Obstruction in the Urinary Tract: A tumor in the urinary tract can block urine flow, causing overflow incontinence. Urinary stones, which are hard stonelike masses that can form in the bladder, may also cause urine leakage.
Risk Factors for Female Urinary Incontinence
There are several risk factors for female urinary incontinence. While some of them are under the individual’s control, others are not. Understanding these risk factors and how they can interact with the causes of incontinence can help individuals better understand their condition. Some of the risk factors include:
- Gender: Due to pregnancy, childbirth, and menopause, women are at higher risk of stress incontinence.
- Age: Age can reduce bladder muscle strength, as well as reduce the amount of urine the bladder can hold. Both of these changes can lead to involuntary releases of urine.
- Weight: Extra weight can put pressure on the bladder and surrounding muscles, causing stress incontinence when sneezing or coughing. This additional weight can also weaken those muscles, leading to urine leakage.
- Smoking: Nicotine irritates the bladder lining and can increase urinary frequency and urgency. Additionally, the coughing that many smokers suffer puts pressure on the pelvic floor muscles and may weaken them, leading to stress incontinence.
- Family History: Having close family members who have female urinary incontinence can increase the chances an individual will develop the condition themselves. This is particularly true for urge incontinence.
- Certain Diseases: Diabetes or neurological diseases may also increase the risk of developing incontinence.
Complications of Untreated or Mistreated Female Urinary Incontinence
If the individual does not seek treatment, or if they seek treatment but do not receive it or receive the wrong treatments, they can suffer a variety of complications. While some of these complications may be expected, such as urinary tract infections (UTI), others may be surprising to individuals who have never thought about female urinary incontinence before they realized they may have the condition.
Some of the complications an individual may face include:
- Skin problems such as rashes, skin infections, sores, or pressure ulcers (prolonged wetness forming open wounds)
- Increased risk of repeated UTIs
- Increased risk of falls and fractures as older women may fall and be injured in their rush to get to the bathroom in time
- Trauma and infection from catheterization
- Irritation and erosion of the urethra
- Sexual dysfunction due to negative body image, fear of leakage during sex, and reduced desire and satisfaction
- Renal dysfunction or damage to the kidneys, though this is rare
- Worsening of the condition due to surgical intervention complications
- Decreased physical activity
- Social, work, and personal relationships deteriorating due to increased isolation out of shame or embarrassment
- Loneliness due to the stigma of female urinary incontinence
- Social isolation, anxiety, depression, low self-esteem, reduced confidence
- Increased burden on caregivers for individuals who require assistance
- High financial burden associated with absorbent pads and other incontinence products
- Absenteeism, decreased work performance, and lower efficiency at work
Female Urinary Incontinence Standard of Care
In some instances, a woman may not realize she has received negligent treatment. If patients are unfamiliar with female urinary incontinence, they are likely also unfamiliar with the standard of care for the condition. This means that whatever treatment they do or do not receive may seem normal or acceptable to them since they have nothing to compare it to. Understanding the typical standard of care for urinary incontinence can be critical to understanding that the care the individual received was negligent.
Generally, healthcare providers prefer to begin with conservative management, such as lifestyle modifications, pelvic floor exercises, and bladder training. They will then move on to more invasive treatments if those do not work, based on the type and severity of incontinence. Treatment begins with the initial assessment and diagnosis of the condition.
Initial Assessment and Diagnosis
When the individual first goes to their healthcare provider about their incontinence issues, the doctor should take a detailed medical and family history. They should also perform a physical exam, urinalysis and urine culture. These help determine whether there is an infection or other abnormality that may be responsible for the incontinence. They will also likely perform a post-void residual measurement test. In this test, the patient urinates into a container that measures the output, then the provider uses a catheter or ultrasound to see how much urine is still in the bladder. A large amount of urine may indicate an obstruction or a problem with the bladder nerves or muscles.
The individual may also be asked to keep a bladder diary in which they record how much they drink and when they urinate each day. They will also track how much urine they produce, and the number of incontinence episodes they had. This information is used in conjunction with the test results and other information to determine whether the individual has female urinary incontinence, what kind they have, and whether it may be temporary or persistent.
Conservative Treatment
Based on the results of the initial assessment and diagnosis, the healthcare provider may start with conservative treatments. Lifestyle modifications like dietary changes, weight loss, and managing constipation are often the first treatment choice. They may also suggest pelvic floor muscle exercises, bladder training, pessaries, or behavioral therapies. If these treatments do not work, or if the incontinence is severe enough, the provider may suggest management through medication.
Management By Medication
Depending on the type of female urinary incontinence, there are several medications that may be useful for treating it. Anticholinergics are beneficial for calming the overactive bladder in urge incontinence. Topical estrogen in low doses may tone and rejuvenate vaginal and urethral tissues. What medication will be used, if medication is used, will depend on the patient’s specific needs.
Surgical Management
There are a variety of surgical treatments for female urinary incontinence. Sling procedures, bulking agents, bladder neck suspension, neuromodulation devices or sacral nerve stimulators are all potential options for treating certain types of incontinence in more severe cases. Electrical and magnetic stimulation devices are noninvasive and may help stress or urge incontinence over the course of several months of treatment.
Ongoing Monitoring and Adjustments
Proper treatment of female urinary incontinence requires ongoing monitoring and adjustments when necessary, based on how the individual is responding to treatment. Additionally, their specific treatment plan should be tailored to their type and severity of incontinence and their preferences and tolerance for different treatments. If you feel that your provider did not properly monitor your treatment or make the necessary adjustments to help you find relief from incontinence, a New Mexico medical negligence attorney with Erin Marshall Law may be able to review your medical records and determine whether you have a claim.
Types of Negligence Claims
Female urinary incontinence typically has three types of negligence claims: pre-operative care, negligence in surgery, and post-operative care. There are different ways in each of these types in which the provider may be negligent, and it is also possible that the provider may be negligent in more than one of these areas.
Pre-Operative Negligence
Pre-operative care involves diagnosing the patient, determining the best treatment option, and getting informed consent from the patient. Negligence in this area can include failing to get informed consent by not fully explaining the risks, benefits, and alternatives to the planned treatment. Other forms of pre-operative negligence include misdiagnosing the severity or type of female urinary incontinence the individual has, and selecting a treatment type that is not appropriate for the type or severity of incontinence the individual has.
Surgical Negligence
Surgical negligence involves negligence during a surgery to treat female urinary incontinence. This may include surgeries that are not properly performed or injuries that occur during the surgery. If the surgeon is not properly trained in the particular surgery the individual is having, and this results in an injury or other issue, this may also give the individual a claim for surgical negligence.
Post-Operative Negligence
Post-operative negligence is negligence that occurs after surgery. This may include failure to diagnose or treat complications from the surgery such as infections, failure to provide appropriate follow-up care, or improper catheter management. This can occur immediately after surgery or in the days or weeks that follow it.
Proving Negligent Treatment of Female Urinary Incontinence
While the standard of care for female urinary incontinence indicates using conservative management before medication or surgical interventions, deviating from that standard does not necessarily indicate negligent treatment. In fact, deviation may be required to provide appropriate treatment in severe cases. Therefore, the individual must be able to prove that the treatment they received was negligent. This is typically done by proving the standard of care was breached, using different kinds of evidence to support their claim.
Proving the Standard of Care Was Breached
Proving the standard of care was breached starts with establishing that a relationship existed between the patient and the provider. This is called the duty of care, meaning that the provider had an obligation to meet the standard of care for the patient. Next, individuals must show that the provider failed to meet the acceptable standard of care, called a breach of duty. The acceptable standard of care is the care that another reasonably prudent provider would give in the same or similar circumstances.
Once those are established, the individual must then prove causation. Causation is the direct link between the provider’s negligent care and the harm the patient suffered. This means the individual must be able to show that because the provider did not meet the acceptable standard of care, they were harmed or their condition was made worse. Finally, they must demonstrate that they suffered actual damages from the provider’s negligence. This is when they must show that they suffered some form of harm that cost them money in some way, such as medical expenses or lost wages. In some cases, the harm may be emotional distress or other psychological harm. This does not mean the individual cannot file a claim, but they may want to consult with an attorney to learn more about their legal rights.
Evidence That Can Support Your Claim
In any medical negligence or medical malpractice claim, evidence to support the claim is needed. While the testimony of the individual or any witnesses can be valuable and assist in proving the claim, other evidence is needed. Medical records are an excellent form of evidence in these claims, as they can be used to document specific instances of negligent treatment by the provider. Expert medical opinions are another form of evidence, and they can review the individual’s medical records and discuss where the standard of care was not met as well as explain what should have been done instead. Documentation of the individual’s symptoms and the impact the condition and its symptoms have had on their quality of life is also strong evidence in female urinary incontinence negligence claims.
Potential Compensation for Negligent Treatment
While there is no set amount of compensation or an average settlement amount for these types of medical negligence claims, it is possible to recover compensation. Individuals may be able to claim damages such as physical injury, pain and suffering, emotional distress, and financial loss from medical expenses, lost wages, and lost earning capacity. In cases where the healthcare provider’s negligence was particularly egregious, punitive damages may also be possible, though this is rare.
Per N.M. Stat. Ann. § 41-5-6, New Mexico has a statutory limit of $750,000 plus medical expenses and a cost of living adjustment, for claims against independent healthcare providers arising after January 1, 2022. Limits are higher when the claim is against a hospital or facility owned by a hospital. Additionally, N.M. Stat. Ann. § 41-5-13 provides individuals with three years from the date the negligence occurred to file their claim, unless the negligent party is a state facility or employee, in which case the statute of limitations is two years. Therefore, it is important to take action quickly to ensure that their claim is not barred and they cannot recover any damages.
How a New Mexico Medical Negligence Attorney Can Help
Female urinary incontinence can be uncomfortable and humiliating and negligent treatment only makes that worse. An experienced New Mexico medical negligence attorney with Erin Marshall Law may be able to review your medical records and other evidence to determine if you have a claim. We may also be able to assist you in gathering evidence, finding medical experts to assist in supporting your claim, and negotiating a settlement or representing you in court. Call our Albuquerque office at (505) 218-9949 to schedule a complimentary consultation.
