March 23, 2023
Stress urinary incontinence – bladder leaks that occur when people cough, sneeze, laugh or exercise – affects 1 in 3 women at some point in their lives. And though it is less common among men, it can impact them, too.
Stress incontinence occurs when there is sudden pressure on the bladder and urethra – the tube that carries urine from the bladder out of the body. Pressure from any activity can cause the sphincter muscle inside the urethra to briefly open, allowing urine to come out.
People with mild stress incontinence only may leak drops of urine during physical activity. In moderate or severe cases, more than a tablespoon of urine may leak out during less strenuous activities, like standing up and bending over, or even during sex.
It is most common among women over 65, but is not considered a normal part of aging, according to the Cleveland Clinic. Vaginal births, obesity, diabetes, chronic coughing, menopause and pelvic surgery increase the risk of stress incontinence.
Stress incontinence can be embarrassing and lead to feelings of anxiety and depression. But doctors encourage people to talk about their symptoms with their health care providers because the condition is treatable.
In most cases, the condition can be treated with floor exercises and lifestyle changes.
Drinking alcohol, coffee, tea or soda can increase incontinence symptoms. Avoiding them can significantly reduce leakage, according to the Mayo Clinic. Preventing constipation by eating high-fiber foods and drinking enough water, and maintaining a healthy weight help to lessen stress incontinence symptoms.
Doctors also recommend strengthening the pelvic floor muscles that support the bladder, rectum and uterus through Kegel exercises. These exercises involve tightening and releasing the muscles in the pelvic floor.
Bladder retraining can help, too. This involves scheduling time to urinate at regular intervals and using deep breathing techniques to control the urge to urinate when it strikes unexpectedly.
Vaginal estrogen creams, gels or patches can help strengthen the vaginal muscles and insertable pessary devices can provide extra support to the bladder and urethra. Some women also find relief with urethral injections that temporarily strengthen the urethral muscle so the sphincter stays closed when pressure is applied.
More severe stress urinary incontinence cases may require surgery. Surgical options include placing a sling – made of synthetic materials or tissues taken from the woman's body – under the urethra. This provides extra support, reducing or preventing leakage. Another option is retropubic suspension surgery, in which the area where the bladder and urethra meet is lifted to provide more support.
More than half of the people who develop stress incontinence also have urge incontinence, a condition in which bladder leakage occurs whenever one feels an urgent need to pee. It is often caused by an overactive bladder. Some people also develop overflow incontinence, which occurs when the bladder is too full or won't completely empty.