Stress Urinary Incontinence (SUI) is a common medical condition that involves the involuntary loss of urine that occurs when pressure on the bladder is increased during physical movement of the body.
When you leak urine involuntarily, whether loss of only drops to tablespoons or more, this is SUI. If it is mild incontinence, you will have light leakage during rigorous activity such as playing sports or exercising, or when you sneeze, laugh, cough, or lift something. If it is moderate or more severe incontinence, you will leak urine even with low impact movement such as standing up, walking, or bending over.
SUI is different from Overactive Bladder (OAB, also known as Urge Incontinence), which is the strong, sudden urge to urinate at unexpected times, such as during sleep, while SUI is leakage. (This fact sheet does not pertain to OAB.)
Estimates of the number of women experiencing SUI vary widely because there is no one definition of the condition. However, urinary leakage is a common medical condition occurring in about one out of every three women at some time in their lives. Among these women, about six in ten have both SUI and OAB. Of this group, about one in three have SUI. Approximately one-third of women age 30 to age 60, and one-third of women under the age of 30, experience urinary incontinence.
SUI is more common among older women, but is not caused simply by aging. It occurs in younger, active, healthy women as well. Caucasian or Hispanic race, being obese, smoking, and chronic cough (which places frequent strain on the pelvic floor muscles that can, in turn, cause bladder leakage) are risk factors for development of SUI. Pregnancy and childbirth increase the chances of SUI because they may stretch, weaken, or damage the pelvic floor muscles, resulting in bladder leakage. Nerve injuries to the lower back and pelvic surgery are also potential causes of SUI because they weaken the pelvic floor muscles.
SUI can interfere with your life and day-to-day decisions about your social activities. You may be embarrassed by your body and feel you can't talk about urinary leakage to your friends and loved ones. SUI can affect the relationship with your partner, especially because you may be embarrassed about having sex. This can lead to feeling isolated and even hopeless.
To know if SUI is a problem for you, ask yourself: Is SUI limiting my daily activities? Have I stopped playing sports? Have I stopped other recreational activities or changed my lifestyle in any way because I'm afraid of urine leakage? Have I become uncomfortable with myself and my body? Am I avoiding sex because I am worried that I may leak urine and be embarrassed? If any of your answers are yes, you need to know that there is hope and there are options to help you better manage and treat SUI.
Treatments for SUI are not perfect. If a woman's SUI cannot be resolved with conservative approaches such as pelvic floor muscle training and daily practice, lifestyle changes, urinary control devices, or surgery, it is recognized that she may need to rely on sanitary or incontinence pads from time to time. Pads may also be an appropriate strategy for women who are not bothered by their urinary leakage or who do not consider it to be a major problem in their life.
Not all health care providers address SUI, so it sometimes goes undiagnosed and untreated. If your health care provider is experienced with SUI they may be able to perform basic tests and suggest lifestyle changes to help reduce urinary leakage or refer you to an incontinence specialist who will perform more specialized tests in order to confirm the diagnosis.*
See the Urology Care Foundation publication, “Talking to Your Doctor About SUI,” for helpful tips.
Surgery is an option when behavioral or nonsurgical treatments fail or if you don't want them. Before going ahead, you should have a clear diagnosis of SUI from an incontinence specialist during a physical examination. Additionally, you should only consider surgery if the SUI significantly bothers you or affects your daily activities. Surgery is also not easily reversible, and depending on the type of surgery, is not always a long-lasting solution.
All surgery carries some level of risk. SUI surgery is not easily reversible, and depending on the type of surgery, is not always a long-lasting solution. It is important to have a full exchange of information and discussion with your provider before making the final decision to go ahead.
SUI surgeries are voluntary procedures that you can have at any time, without risk that waiting will cause you harm. Unlike some other medical conditions, there is no evidence that delaying surgery for SUI makes the outcome worse.
There are currently no approved drugs in the United States to treat SUI.
* You may be referred to a specialist in incontinence and SUI, such as a urologist. You can use our Find-A-Urologist tool to find a urologist in your area. Choose "incontinence" as a "special interest area" to find urologists who said they were interested in helping patients who leak urine or have SUI.