What is Stress Urinary Incontinence?

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.

How do I know if I have SUI?

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.

How is SUI different from Urge Incontinence, or Overactive Bladder (OAB)?

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.)

How common is SUI?

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.

How did I get SUI?

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.

Why does it matter if I have SUI?

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.

Is it a problem that I use pads?

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.

What should I do if I think I have SUI?

• You can make an appointment with your primary health care provider, who may do a basic evaluation or refer you to a specialist.
• You can talk with friends, or learn more about SUI online - go to UrologyHealth.org/SUI for more information.
• You can keep a bladder diary (like a food diary) to record your urine leakage episodes. This tool can be helpful to your health care providers. Please check out Bladder Diary.

Where can I find professional help?.

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.*

I feel uncomfortable talking about my urine leakage even with my doctor. What should I do?

See the Urology Care Foundation publication, “Talking to Your Doctor About SUI,” for helpful tips.

Should I think about surgery to cure my SUI?

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.

Are there any risks with surgery?

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.

It's not convenient for me to have surgery right now. Can I wait?

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.

I don't want surgery. What else can I do?

• You can keep your weight in a healthy range, stay in good overall health, and do not smoke. Weight loss is especially important for obese women and can reduce or eliminate SUI.
• Pelvic Floor Muscle Exercises. Your provider can help you locate the pelvic floor muscles and teach you exercises to strengthen them each day in order to help prevent stress urine loss.
• Urinary control devices are good for women who are not physically fit or interested in other treatments. They are a way of reducing pressure inside the pelvis or supporting the bladder, neck and urethra, which can then reduce stress urine leakage. Your provider can explain these and help you decide which if any are appropriate for you.

Are there any drugs I can take for SUI?

There are currently no approved drugs in the United States to treat SUI.

Common myths about SUI:

• “It's a normal part of being a woman.”
• “My mother had SUI, so I have it - it's hereditary.”
• “SUI is a normal, inevitable part of aging - it only happens to older, not younger women.”
• “Urine leakage happens because of a dropped bladder.”
• “I could have prevented it with pelvic exercises.”
• “SUI can't be treated.”
• “Surgery is the only way to treat SUI.”
• “If you get treatment early, you'll prevent it from getting worse.”
• “SUI surgery is not permanent and will only last a few years.”

* 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.

1 in 3 women will experience SUI in their lifetime. Talk to your doctor and get the help you need.

For more copies of this and other materials about SUI, incontinence and other urologic conditions, visit UrologyHealth.org/Order or call 1-800-828-7866.

For more information, contact:

Urology Care Foundation™
1000 Corporate Blvd.
Linthicum, MD 21090
1-800-828-7866
UrologyHealth.org