Stress urinary incontinence is a type of incontinence in which physical activity or movement causes the accidental leakage of urine. Often affecting women, stress urinary incontinence may occur when exercising, lifting heavy objects, laughing, sneezing, or coughing. Any activity or movement that puts pressure and stress on the bladder could cause urine leakage.
Inside the body, stress urinary incontinence may occur when the structure around the bladder weakens. Pelvic floor muscles may stretch and loosen after pregnancy and childbirth. The sphincter muscle that helps control urine retention in the bladder can also lose strength. The condition may also relate to pelvic floor surgery, hysterectomy, obesity, age, or hormone imbalance.
How to Manage Stress Urinary Incontinence
The first step in managing stress urinary incontinence is realizing that this is a common condition that needs to be discussed. Patients are encouraged to speak with their primary care physician about their symptoms and to also see a board-certified urologist with experience in diagnosing and treating this condition. With a thorough review of your medical history and lifestyle habits, your doctor can make at least one recommendation for treatment. Common options include:
Lifestyle Modifications
Women may improve the symptoms of stress urinary incontinence by strengthening their pelvic floor muscles. This may be achieved with Kegel exercises, neuro-stimulation, biofeedback, and the avoidance of certain trigger foods and beverages. Alcohol and caffeine are stimulants that may increase one’s need to urinate more frequently. Accidental leaks may also be prevented by using the bathroom several times throughout the day.
Medications
While stress urinary incontinence is not caused by psychological or emotional stress, studies have shown that Duloxetine, an anti-depressant medication, can improve symptoms. This medication works by interrupting the transmission of nerve impulses to the muscles, allowing the muscles that help control the bladder to contract more intensely.
Non-surgical Devices
Women with stress urinary incontinence may talk with their urologist about the use of a vaginal pessary to control bladder function. A vaginal pessary is a ring-shaped device with two bumps, one that sits on each side of the urethra. The bumps create a barrier that prevents urine leakage. Vaginal pessaries may be disposable devices that a woman can easily insert herself, similar to a tampon.
Surgery for Urinary Incontinence
Surgery is considered a last resort when conservative therapies have failed to improve urinary continence. Surgical intervention is designed to improve the integrity of the sphincter or to support the bladder neck using medical-grade mesh or donor tissue.
