What is stress incontinence?
Having urine leak while you are coughing is a medical condition known as stress urinary incontinence (SUI).
SUI occurs when urine leaks out of the bladder due to an increase in abdominal pressure. Any time that pressure increases to the point where it becomes more than the pressure needed to keep urine inside your bladder, a leak can occur. Activities that cause extra pressure include:
This is different than other types of urinary incontinence, such as urge incontinence, which is caused by an abnormal contraction in the bladder.
In general, stress incontinence occurs when only a small amount of urine leaks out. If your bladder is completely emptying without your control, then that’s a different medical problem. Stress incontinence just means that when there’s some kind of added “stress” on the bladder, it causes your bladder to leak a little urine. The condition can severely impact a person’s quality of life. It can cause them to avoid activities they may normally enjoy.
Causes of stress incontinence
Stress incontinence is more common in women than men. Around 13 percent of women between the ages of 19 and 44 will develop stress urinary incontinence, while 22 percent of women aged 45 to 64 years have the condition.
And while urine leakage doesn’t just happen to women, it’s a common condition for many mothers because the bladder muscles and the muscles surrounding the bladder can become weakened through the stress of pregnancy and childbirth. The overall incidence of stress incontinence is 8 percent higher in women who have given birth. And women who have delivered a baby vaginally are twice as likely to develop stress incontinence compared to women who have delivered via cesarean.
There are different factors that can cause stress incontinence. For women, the most common cause is pregnancy and childbirth. Men might develop stress incontinence after a prostatectomy. Obesity also increases the risk of leakage.
Other risk factors for stress urinary incontinence include:
- pelvic surgery
- chronic constipation
- carbonated drinks
- medical conditions
- chronic pelvic pain
- low back pain
- pelvic organ prolapse
Treatment for stress incontinence
Stress incontinence is manageable. The first thing you should do is visit your doctor to discuss physical therapy to strengthen your pelvic floor. Especially for women who have had a baby, pelvic floor strengthening is key for improving bladder control.
Pelvic floor therapy
In some other countries, pelvic floor therapy is a routine part of a woman’s care after having a baby. In the United States, however, pelvic floor therapy is not something that most mothers are educated about. The best route is prevention, so if you are pregnant or plan to get pregnant, talk with your doctor about ways you can safely maintain and strengthen your pelvic floor throughout pregnancy and during the postpartum period.
If you are past your childbearing years, the good news is that’s never too late to strengthen your pelvic floor. The bladder is actually supported by a complex network of muscles and no matter what age you are, muscles can be strengthened. For women with stress incontinence, the muscles that hold up the pelvic floor, specifically the levator ani (LA), are generally weakened. Physical therapy for SUI focuses on strengthening the LA muscle to improve bladder control. Essentially, patients practice controlling and tightening the muscles they would use when holding in urine. They also regularly tighten and contract the muscles over a period of several weeks and months.
Other treatment options include interventions such as a vaginal cone to support the bladder and medication that may relieve the incontinence.
When stress incontinence is very severe, surgery is considered. One study found that up to 20 percent of women may need surgery for stress incontinence or a pelvic organ prolapse (two things which usually go hand-in-hand) by the time they are 80 years old. Today, more women are getting surgery to treat SUI than ever before.
What is the outlook for stress incontinence?
If you have stress incontinence, know that it is a very common and manageable condition. If you have SUI, you can try the following tips for living with stress incontinence:
Don’t be afraid to discuss your condition with your doctor. Many people miss out on treatment options because they don’t talk to their doctor. Talking about it can lead to improvement in your condition.
Consider a regular bathroom routine. Training your bladder to empty at regular, timed intervals, such as every two to three hours, may help you reduce your incidences of leaks.
Add strength training to your exercise routine. Movements that add resistance training to your body will help strengthen your entire core. Just be sure to work with a certified personal trainer who can monitor you for proper form.
Cut back on caffeine. Caffeine will flush fluid from your body, causing you to urinate even more. If you can’t quit coffee completely, at least cut back or make sure you only drink your morning joe at home. Be sure to empty your bladder before you leave the house.