Female Urinary Stress Incontinence

Written by Rose Kivi
Medically Reviewed by George Krucik, MD

Female Urinary Stress Incontinence

Female urinary stress incontinence is the involuntary release of urine during any physical activity that puts pressure on your bladder. This potentially embarrassing condition differs from general incontinence in that it happens when the body is under immediate physical stress. Activities that can put stress on your bladder include coughing, sneezing, laughing, lifting heavy objects, or bending over. This condition is particular to women, many of whom experience symptoms after muscles have been weakened due to a vaginal childbirth, following menopause, or during pregnancy.

Stress incontinence can occur at any age. The risks of it developing increase with pregnancy and as you age. Stress incontinence is the most common type of urinary incontinence in women.

What Causes Female Urinary Stress Incontinence?

Female urinary stress incontinence occurs when the pelvic muscles that control the release of urine and support your bladder weaken. These muscles can become weaker as you get older. The muscles often weaken after menopause due to low estrogen levels. Childbirth, pelvic surgery, and injury to your urethra can also weaken the muscles.

Factors That Can Worsen Female Urinary Stress Incontinence

Certain factors can aggravate symptoms and increase the risk of female urinary stress incontinence.

Food and Drinks

The following food and drinks may make your stress incontinence worse:

  • alcohol
  • caffeine
  • soda
  • spicy foods
  • citrus fruits

Overall Health

The following health factors may make your stress incontinence worse:

  • urinary tract infections
  • obesity
  • frequent coughing
  • medications that increase urine production
  • nerve damage or excessive urination from diabetes

Lack of Treatment

Female urinary stress incontinence is usually treatable. However, many women do not seek treatment. According to the Agency for Healthcare Research and Quality (AHRQ), more than 50 percent of women do not get treatment for their stress incontinence. (AHRQ)

Do not let embarrassment stop you from getting treatment. Female urinary stress incontinence is common, and your doctor has most likely encountered it many times.

How Is Female Urinary Stress Incontinence Diagnosed?

To make a diagnosis, your doctor might perform a pelvic exam in addition to one or more of the following tests:

  • During a urinary stress test your doctor will ask you to cough while you are standing to see if you involuntarily leak urine.
  • During a pad test you will be asked to wear a sanitary pad during exercise to see how much urine you are leaking.
  • A urinalysis enables your doctor to determine if you have a urinary tract infection.
  • A post-void residual (PVR) test measures how much urine is in your bladder after you have gone to the bathroom.
  • A cystometry test measures pressure in your bladder. It also measures the flow of your urine.
  • X-rays with contrast dye help your doctor spot abnormalities in your urinary tract.

How Is Female Stress Urinary Incontinence Treated?

There are several types of treatment available. Treatment options include lifestyle changes, medications, nonsurgical treatments, and surgeries.

Lifestyle Changes

Make regular trips to the restroom to reduce the chance of urine leakage. Your doctor may also suggest that you drink fewer fluids and avoid certain activities, such as jumping and running. If you are overweight, losing weight can help take pressure off your stomach and bladder. Your doctor can help you develop a weight-loss plan.

Medications

Your doctor may prescribe medications that reduce bladder contractions. These include drugs like Atrovent, Cogentin, and Spiriva. He or she may also try drugs designed to treat an overactive bladder such as Vesicare, Enablex, or Oxytrol.

Nonsurgical Treatments

Kegel exercises strengthen your pelvic muscles. To do these exercises, you squeeze the muscles that stop the flow of urine. Your doctor will show you the right way to do these exercises. Done regularly, these exercises can strengthen your muscles, allowing you to control when urine is released from your body.

Biofeedback is a type of therapy that is used when you are having trouble learning how to do Kegel exercises. The therapy uses small sensors that are placed inside or near your vagina. Your doctor will have you try to do Kegel exercises. The sensors record your muscle movements to help you identify if you are using the correct muscles.

A vaginal pessary is a small ring that is placed inside your vagina to support your bladder and compress your urethra. Your doctor will fit you with the correct size vaginal pessary and will show you how to remove it for cleanings.

Surgery

Your doctor may recommend surgery if other treatments fail. Types of surgery include:

  • injectable therapy, in which collagen is injected into your urethra to reduce incontinence
  • tension-free vaginal tape (TVT) surgery, in which mesh is placed around the urethra to give it support
  • vaginal sling surgery, in which a sling is placed around the urethra to support it
  • anterior or paravaginal vaginal repair surgery to repair a bladder that is bulging into the vaginal canal
  • retropubic suspension surgery to move the bladder and urethra back into their normal positions

Lowering Your Risk for Developing Stress Incontinence

Doing Kegel exercises while you are pregnant and after your pregnancy may reduce your chances of developing urinary stress incontinence.

Can I Cure Stress Incontinence?

Lifestyle changes, medications, and nonsurgical treatments rarely cure stress incontinence. However, they can reduce or prevent the symptoms. However, according to NYU Langone Medical Center, surgery cures urinary stress incontinence in up to 80 percent of women. (NYU)

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