Stress Urinary Incontinence

Urine leakage while walking, coughing, or sneezing is a common problem

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Stress urinary incontinence (SUI) happens when you experience an involuntary urine leakage with physical activity, coughing, sneezing, or other actions that put pressure on the bladder. Experts say stress urinary incontinence affects one in three women at some point in their lives.

Stress urinary incontinence is seldom talked about due to embarrassment and stigma. When it leads you to restrict physical exercise, walking, and other activities, it is time to start talking to your doctor and finding a solution.

Symptoms of Stress Urinary Incontinence

Urine leakage in SUI can range from a few drops to a heavier release of urine. Some women experience SUI only during high-impact activities, such as jumping, or high-stress actions, such as sneezing. But other women have urine leakage during moderate activities, such as walking or getting out of a chair. SUI is different from urge incontinence or overactive bladder syndrome, which is a sudden, uncontrollable need to urinate.

Who Is at Risk of SUI

 Experts say one in three women experiences SUI at some point in her life. SUI is more common in older women but it also affects younger, active women. Risk factors for SUI include being overweight or obese, smoking or having a chronic cough. SUI more common in women who have gone through pregnancy and childbirth. Nerve injury and pelvic surgery can also increase the risk of SUI.

While many women experience SUI, it shouldn't be considered to be a normal part of aging or a sign of aging.

Getting Help for Stress Urinary Incontinence

Many women use mini-pads or incontinence pads as a simple way to address SUI. That can work for small amounts of leakage. But if you realize that you are limiting your physical activity or social life due to SUI, it is time to seek help.

  • Learn about your options: The American Urological Association Foundation has a patient resource page with a patient guide to SUI, treatment guides for men and women, frequently asked questions, and tips for talking to your doctor about SUI.
  • Bladder diary: Keeping a diary of your fluid intake and urine output can help your doctor understand and assess your problem. The AUA Foundation has free instructions and a printable bladder diary online.
  • Find the right doctor: A primary care physician may be able to provide the needed help, and may offer several conservative solutions. But if SUI is a problem that is restricting your lifestyle and you need a permanent solution, there are surgical procedures that can address it. Ask for a referral to a urinary incontinence specialist if your primary care doctor isn't giving you a solution that enables you to live as you wish to live.

Conservative Solutions for SUI

These methods can help reduce the number of SUI episode or their severity:

  • Try pelvic floor muscle training.
  • Maintain a healthy weight.
  • Drinking just the right amount of fluids each day—not too little and not too much—is important for good health, reducing constipation and not overloading the bladder. Restricting caffeine, alcohol, and drinks and food that may be irritants might be suggested. However, a 2016 review of studies found that coffee and caffeine consumption was not associated with incontinence risk.
  • Stop smoking in order to reduce coughing and treat chronic coughs.
  • Urinary control devices: These can be as simple as wearing a tampon. But there are other devices available, such as urethral inserts and patches and a vaginal incontinence pessary.
  • Medications: While there are medications that are approved to use for other types of incontinence, they are not approved for SUI. Topical low-dose estrogen can be used in the vagina to provide lubrication and this may provide some symptom relief.

Surgical Solutions for SUI

Surgery can help this problem and may even cure it.

  • Urethral bulking: This is an office procedure where substances are injected through a cystoscopic procedure to bulk up the urethral muscles. It often must be repeated.
  • Bladder neck suspension (retropubic colposuspension): This is a more invasive surgery to reposition the bladder neck behind the pubic bone.
  • Slings: This procedure is now the most common and is done through the vagina rather than an incision. Strips of material are placed beneath the bladder neck and urethra to support them in a hammock. The material can be synthetic or the women's own tissue. This procedure has a faster recovery time than the bladder neck suspension surgery. A male sling is also available as a mesh tape that puts pressure on the urethra.
  • Inflatable artificial sphincter: This is used mostly for men and requires the device to be surgically implanted.

A Word From Verywell

Stress urinary incontinence can be a distressing problem. You can try a variety of approaches to find the one that fits your lifestyle the best. Your symptoms are likely to get better with nonsurgical treatment, while surgery may cure the problem. It's okay to delay surgery as that won't make a difference in getting a good outcome.

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