What Is Stress Urinary Incontinence? Causes, Diagnosis, Treatment
- Medically checked
What Is Stress Urinary Incontinence?
Stress urinary incontinence is the involuntary loss of urine that occurs during physical activities such as coughing, sneezing, bending, lifting, or standing. The leakage may involve just a few drops or a larger amount. Approximately one in three women over the age of 50 experiences urinary incontinence. Many women avoid discussing it openly, which delays diagnosis and treatment—despite the fact that, in most cases, effective solutions exist.
What Causes Stress Urinary Incontinence?
- Genital prolapse, resulting from weakened pelvic floor muscles
- Multiple pregnancies or deliveries, and obesity, which increase intra-abdominal pressure
- Menopause, due to reduced hormone levels and tissue tone
- Neurological disorders, such as spinal trauma, diabetes mellitus, Parkinson’s disease, and multiple sclerosis
- Certain surgical procedures, especially those addressing genital prolapse
- Medication use, particularly prolonged use of diuretics for hypertension
Stress Urinary Incontinence: Diagnosis
Diagnosis starts with a clinical examination and medical history taken by your doctor. In some cases, non-invasive and painless tests, such as urodynamic studies, may be required. Once a diagnosis is confirmed, your doctor will recommend treatment, which may or may not involve surgery. No matter which path you choose, most patients experience significant improvement, and some are permanently cured.
How to Prepare for Your Doctor’s Appointment
To make your consultation as productive as possible, consider the following:
- Prepare a list of symptoms you are experiencing
- Note any medications you currently take, especially those that may irritate the bladder
- Write down any questions you would like your doctor to address, such as:
- What are the treatment options for this condition?
- Can it be treated without surgery?
- Can it worsen or lead to complications over time?
- Does body weight influence urinary incontinence?
- What tests are necessary to identify the cause?
Stress Urinary Incontinence: Treatment Options
Several treatment methods can help manage mild to moderate stress urinary incontinence effectively:
Kegel Exercises
These exercises aim to strengthen the pelvic floor muscles by repeatedly contracting and relaxing the muscles responsible for bladder control. The exercises should be done without engaging the abdominal, gluteal, or thigh muscles. Patients are advised to perform them daily—10 repetitions per set, five sets per day—for optimal results.
Weight Management
Excess body weight increases intra-abdominal pressure, which can aggravate or contribute to urinary incontinence. Weight loss can significantly reduce symptoms and improve pelvic floor support.
Pessary Devices
An intravaginal pessary can help reduce urinary leakage by supporting the bladder and urethra, maintaining their proper anatomical alignment. While effective, potential drawbacks include a sensation of a foreign body and a risk of vaginal irritation or infection, especially without regular cleaning and follow-up.
Surgical Intervention
When conservative treatments do not offer adequate relief, surgery may be considered. Modern surgical procedures for stress urinary incontinence are minimally invasive, performed via laparoscopic or transvaginal approaches, and offer shorter recovery times and reduced complication rates.
There are several types of surgical options available:
- Laparoscopic Burch Colposuspension:
This procedure involves lifting and stabilizing the bladder neck and proximal urethra by attaching them to the Cooper’s ligaments. It is well-suited for sexually active women and does not involve synthetic mesh. The risk of infection is low, and recovery is typically fast.
- TOT/TVT Procedures (Transobturator Tape/ Tension-Free Vaginal Tape):
These mesh-based techniques elevate and support the mid-urethra to restore continence. They are associated with high long-term success rates and minimal complication risks.
- Kelly Plication:
This tissue-based surgery reinforces the bladder neck and urethra without using synthetic material. It is generally considered when mesh use is contraindicated or undesired.
- Artificial Urinary Sphincter Implantation:
Used in select cases, especially when other procedures have failed or are not suitable. It involves implanting a mechanical device that mimics the function of a healthy urinary sphincter.
Stress urinary incontinence is common among women over the age of 45. Effective treatment typically involves a combination of lifestyle adjustments, pharmacological therapies, targeted physical exercises, and—when necessary—surgical intervention. These methods can significantly improve quality of life and, in many cases, resolve the condition entirely.
