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What is Stress Urinary Incontinence?
1 in 3 women will experience stress urinary incontinence (SUI) in their lifetime-it is very common. It occurs when an activity, like laughing or coughing, causes urine to leak out. The amount of urine loss can be anything from a few drops to tablespoons or more.
Incontinence is not just a medical problem. It affects a woman's emotional, psychological, and social well-being. Many women become afraid to participate in normal activities that might take them too far from a toilet. The good news is that most cases of SUI can be treated successfully.
What triggers SUI?
Mild SUI is often triggered by some sort of activity, like exercise or from sneezing, laughing, coughing or lifting. Moderate or severe SUI occurs with any type of small movement, such as standing up, walking or bending over.
What increases my risk of getting SUI?
SUI is more common among older women, but age and gender are not the only factor. Several factors contribute to SUI by stretching, weakening or damaging the pelvic floor muscles. Risk factors include:
- Caucasian or Hispanic race
- Overweight or obesity
- Smoking
- Chronic coughing
- Pregnancy and childbirth
- Nerve injuries to the lower back and
- Pelvic surgery
How is SUI diagnosed?
Your health care provider may use several methods to diagnose your SUI. It's helpful to keep a bladder diary before your appointment. The diary can be helpful in figuring out why and when your leakage occurs and what you might be able to change in your everyday life to prevent it from happening.
Review your medical history
Your health care provider may ask about the urine leaks-when they occur, what you were doing at the time, and how they made you feel. Talking about your leakage problems can be embarrassing. But, providing more information will help your health care provider determine the cause of your leakage.
Conduct a physical exam
Your health care provider may give you a pelvic exam to find out the strength or weakness of your pelvic floor muscles (the muscles that support your bladder and other organs) and sphincter, along with checking your overall health. You might be asked to:
- Wear a pad while doing activity or exercising to see how much leakage there is during physical activity.
- Start a bladder diary, if you haven't already started one.
Conduct urodynamic tests
Your health care provider may perform these tests to determine at what stage of pressure your full bladder begins to leak and how your bladder empties.
How is SUI treated?
Today, more than ever, help is available. SUI usually can be cured, treated, or managed so that bladder control problems don't interfere with a healthy and active lifestyle.
Non-surgical Options
Pelvic Floor Muscle Exercises
Also called Kegels, these exercises strengthen your pelvic floor muscles, the muscles that help support the bladder and other organs. Squeezing and relaxing these muscles makes them stronger and helps to reduce urine loss. Read Bladder Control: Strengthening Your Pelvic Floor Muscles to learn more. Be sure to practice the exercises daily!
Lifestyle Changes
By making a few changes in your everyday life, you can help reduce the impact SUI has on you. These include losing weight, stopping smoking and maintaining good overall health.
Medical devices
Devices, inserts or patches help reduce leakage at times of high activity and are placed directly in the urethra (the tube that carries urine out of the body).
Absorbent Pads
For some women, the best option is to use sanitary or incontinence pads. If you've tried other options and they aren't working, pads may be a good strategy, particularly if the leakage is not a major problem in your life.
Surgical Options
It is important to discuss your options with your doctor. Questions you can ask so you can make the best decisions for you include:
- Which surgery is best for me?
- What are the risks with the surgery?
- Will surgery fix my SUI?
- How long is the recovery?
- Will my insurance pay for surgery?
Urethral Bulking
Materials are inserted into the layers of the urethra (the tube that carries urine out of the body) to bulk it up and help tighten the muscle valve. This procedure is done in the doctor's office.
Slings
This is the most common surgery for leakage and is done in about 30 minutes. A sling is inserted under the urethra to give support to prevent leakage of urine.
Bladder Neck Suspension
This surgery, also called retropubic suspension, is not as common as sling surgery. During this surgery, the neck of the bladder is sewn to the back of the pubic bone.
What should I do?
There is more you can do:
- Learn more about SUI at our For Patients page.
- Record urine loss in a bladder diary to help your doctor ensure proper management and treatment.
- Talk to your doctor to get the help you need.
- Check to see if an incontinence support group is available in your community.