A friend of mine loves a good joke. She loves a great big belly laugh. But she jokes that whenever she laughs now, she needs a "diaper." Like many women after their child-bearing years, she leaks urine when laughing, sneezing or exercising.

To be honest - what woman hasn't? So we all know how unsettling urinary incontinence can be. But for many American women, incontinence isn't limited to laugh and some occasional leakage. It is a daily occurrence that profoundly affects activities and lifestyle.

Pelvic organ prolapse can impose similar restrictions on women. It occurs when structures like the bladder, uterus or vagina bulge into the vaginal wall causing pelvic pressure or pain and other symptoms.

Incontinence and prolapse often can be treated or cured, and should not be a source of embarrassment. After all, millions of women are enduring your same experience. It is estimated that 17 million women in the U.S. are coping with urinary incontinence and 14 million with prolapse.

Here's some basic information on incontinence and prolapse. It's reassuring to know that new technology is generating positive, long-term results and is changing how doctors treat these health issues. Talk to your doctor and visit www.AmericanMedicalSystems.com for more information.

Urinary incontinence
Q. Why does it happen?

A. Just below your bladder is the sphincter muscle. It surrounds the urethra, the canal that carries urine from the bladder. When the sphincter muscle tightens, it holds urine in the bladder. When it relaxes, the bladder contracts and the urethra opens, allowing urine to flow outside the body.

Urinary incontinence often occurs because pelvic muscles and tissue have been weakened, preventing the urethra from closing tightly enough to hold urine in the bladder.

A number of situations can weaken muscles and tissue, leading to urinary incontinence:

• Pregnancy and vaginal childbirth
• Aging and genetic factors
• Medical conditions (e.g., hysterectomy, multiple sclerosis, Parkinson's disease, stroke)
• Infections and medications
• Obesity

Q. What can be done?
A. One of the most significant advances in treatment of urinary incontinence is the urethral support sling.

A urethral support sling involves a minimally invasive surgery in which mesh is placed under the urethra to give it a point of support. The mesh sling functions much like a hammock that your urethra rests on to prevent accidental urine leakage.

The mesh is made of a narrow strip of loosely woven strands of polypropylene. It is porous so your body tissues can grow into it to provide optimal support.

Most patients are continent immediately following the procedure and can resume normal, non-strenuous activities within a few days.

Pelvic organ prolapse
Q. Why does it happen?

A. Your pelvic organs are held in place by supporting ligaments and connective tissues. Prolapse occurs when these ligaments and muscles are weakened or damaged due to:

• Pregnancy
• Childbirth
• Menopause
• Previous surgery
• Obesity

Q. What Can Be Done?

A. Prolapse repair systems use a strip of mesh-like material that is placed in your body to return prolapsed organs to a more normal anatomical position and strengthen structures around your vagina to maintain support. The use of mesh for reinforcement is not new—it has been used extensively in surgery since 1965.

The mesh is made of loosely woven strands of polypropylene. It conforms to your normal anatomy and is porous so your body tissue can grow into it, providing a framework of support.

Mesh is used to repair all types of pelvic organ prolapse:

• Vaginal occurs when the apex of the vagina descends into the vaginal canal.
• Cystocele occurs when the bladder pushes into the vaginal wall.
• Enterocele occurs when the intestine bulges into the vaginal wall.
• Rectocle occurs when the rectum bulges into the vagina.

Most women experience immediate results after a prolapse repair system is placed.