Description

Urinary incontinence is the loss of bladder control. Stress incontinence happens when the movement or activity puts pressure on the bladder, causing urine to leak. The movements include coughing, laughing, sneezing, running or heavy lifting. Stress incontinence is not related to the mental stress.

Stress urinary incontinence is not the same as urge incontinence and overactive bladder (OAB). These conditions cause the bladder muscle to spasm. This leads to a sudden need to urinate quickly. Stress urinary incontinence is much more common in women than in men.

If you have stress incontinence, you may feel embarrassed. You may limit your work and social life because I don't want to be with others. It is also possible to not do physical or fun activities.

The treatment can help you manage stress urinary incontinence, and improve your quality of life.

Symptoms

If you have stress incontinence, you may leak urine when you:

  • Coughing or sneezing.
  • Laugh.
  • You bend over.
  • Lifting something heavy.
  • Exercise.
  • To have sexual intercourse.

Perhaps there is no leakage of urine each time you do one of these things. But any activity that puts pressure on the bladder and can make the leak more likely. To have a full bladder increases the chances of leakage.

When to see a doctor

Talk with your health care professional if your symptoms bother you or get in the way of daily activities like work, hobbies, and social life.

Causes

Stress incontinence happens when certain muscles, and other tissues related to urinate weaken. These include the muscles that support the urethra, called the pelvic floor muscles and the muscles that control the release of urine, called urinary sphincter.

The bladder expands as it fills with urine. The more often, the valve-like muscle in the tube that carries urine out of the body, called the urethra, remain closed as the bladder expands. This keeps you from leaking urine until you get to a bathroom.

But when the muscles are weakened, there is nothing that puts the power in your stomach and the muscles of the pelvis, putting pressure on the bladder. Sneezing, bending over, lifting, or laughing hard, for example, can cause urine leakage.

Stress urinary incontinence female

On the people assigned to women in childbirth, the pelvic floor muscles and urinary sphincter can lose strength due to:

  • Delivery. Tissue or nerve damage during the delivery of a child can weaken the pelvic floor muscles or the sphincter. Stress urinary incontinence from this damage may begin soon after birth or occur years later.

Male stress urinary incontinence

In persons assigned male at birth, the pelvic floor muscles and urinary sphincter can lose strength due to:

  • Surgery of the prostate. The treatment for prostate cancer often involves surgery to remove the prostate gland, called a prostatectomy. This surgery is the most common factor that leads to stress urinary incontinence. This procedure can weaken the sphincter, which is located just below the prostate gland and goes around the urethra.

Other factors

Other factors that may cause stress urinary incontinence worse for men and women include:

  • Diseases that cause chronic cough.
  • Obesity.

Risk factors

The factors that increase the risk of stress urinary incontinence include:

  • Age. The physical changes that occur with age, such as the muscles becoming weaker, can make you more likely to get stress urinary incontinence. But some stress urinary incontinence can occur at any age.
  • The weight of the body. People who are overweight or obese have a higher risk of stress urinary incontinence. Excess weight increases the pressure on the abdominal and pelvic organs.

For women, risk factors also include:

  • Type of delivery. People who have had a vaginal birth are more likely to suffer from urinary incontinence are those who have had a c-section. Have more than one child also increases the risk.

Complications

The complications of urinary incontinence may include:

  • Emotional discomfort. If you have stress incontinence, you may feel embarrassed. You can interrupt your work, social life, relationships and even your sex life. Some people are embarrassed that they need pads or incontinence garment.
  • Mixed urinary incontinence. It is common to have both stress incontinence and urge incontinence. Urinary incontinence results when you tighten the muscles of the bladder and cause an urgent need to urinate. People with this condition may have frequent urination, urination at night and the urgency of urination, with or without associated incontinence. This is called overactive bladder.
  • Skin rash or pain. Prolonged contact with urine can cause the skin to pain or break. This can happen with severe incontinence if you do not make use of moisture barriers or diapers. Change pads often and use of continence pads in place of sanitary pads to prevent sores on the skin.

Diagnosis

During your visit, your health care professional for clues on the cause of your symptoms. The appointment is likely to include:

  • Voiding diary that tells you how much you drink and when and with what frequency of urination.
  • History of medicine.
  • Physical exam. This could include a pelvic examination in women, and a rectal examination.
  • Test of the sample of urine for infection or traces of blood.
  • Brief neurological exam to see how the pelvic nerves work.
  • Urinary stress test, in which a health care professional looking for a loss of urine when you cough or bear down with a full bladder.

Testing the function of the bladder

Common cases of urinary incontinence usually do not need other tests. But sometimes, your healthcare provider may order tests to see how well your bladder, urethra, and sphincter of work.

The function of the bladder tests may include:

  • The measurement of the amount of urine left in the bladder after urinating.You may have this test if there are concerns about his being able to empty the bladder completely. People who are older, have had a surgery of the bladder or you have diabetes you may need this test. A specialist uses an ultrasound, which converts the sound waves into a picture. The test shows the amount of urine left in the bladder after urinating. Sometimes, the test involves passing a thin tube, called a catheter through the urethra into the bladder. The catheter to drain the urine that is why it can be measured.
  • The measurement of pressures in the bladder.Urodynamics is a test that measures the pressure in your bladder during filling and emptying. This test can verify the stress urinary incontinence and the strength of the pelvic floor muscles. Some health professionals use these results to choose a surgical approach. A catheter is used to fill the bladder slowly with the warm fluid. As the bladder fills, you may be asked to cough or bear down to check for leaks. This procedure can be used with a pressure-flow study. This shows how much of the pressure off your bladder is used to empty all the way.
  • The cystoscopy. This test uses a scope of application that is placed in the bladder to look for the conditions in the bladder and urethra that may be causing your symptoms. This procedure is usually performed in a doctor's office.

The measurement of the amount of urine left in the bladder after urinating. You may have this test if there are concerns about his being able to empty the bladder completely. People who are older, have had a surgery of the bladder or you have diabetes you may need this test.

A specialist uses an ultrasound, which converts the sound waves into a picture. The test shows the amount of urine left in the bladder after urinating. Sometimes, the test involves passing a thin tube, called a catheter through the urethra into the bladder. The catheter to drain the urine that is why it can be measured.

The measurement of pressures in the bladder. Urodynamics is a test that measures the pressure in your bladder during filling and emptying. This test can verify the stress urinary incontinence and the strength of the pelvic floor muscles. Some health professionals use these results to choose a surgical approach.

A catheter is used to fill the bladder slowly with the warm fluid. As the bladder fills, you may be asked to cough or bear down to check for leaks. This procedure can be used with a pressure-flow study. This shows how much of the pressure off your bladder is used to empty all the way.

Treatment

Your health care professional may suggest a mixture of shapes for the treatment of stress urinary incontinence. If you have a urinary tract infection, you receive treatment for the condition before starting the treatment for stress urinary incontinence.

Behavioral therapies

Behavioral therapies can help to have less or none of the stress urinary incontinence. Treatments may include:

  • Exercises for the pelvic muscles.A member of your care team physician or a physical therapist can help you learn how to do Kegel exercises to strengthen the pelvic floor muscles and urinary sphincter. For Kegel exercises to work, you must do regularly. A technique called biofeedback can be used in conjunction with Kegel exercises to do exercises that work better. Biofeedback involves the use of pressure sensors or electrical stimulation to the proper guidance of the muscle contractions. Once your muscles are strong, you can tighten these muscles before doing anything that would cause leaks to prevent leakage.
  • The intake of liquids. Your health care professional may suggest how much and what type of fluid you should drink during the day and the night, and when. But don't limit yourself to what you drink so much that your body loses too much fluid, called dehydration.
  • Changes healthy lifestyle. Quitting smoking, losing excess weight or treat a cough that is continuous decrease your risk of stress urinary incontinence and improve your symptoms.
  • The training of the bladder. Your health care professional may suggest a program for the use of the toilet, if you have mixed incontinence. To urinate more often can help with urge incontinence.

Exercises for the pelvic muscles. A member of your care team physician or a physical therapist can help you learn how to do Kegel exercises to strengthen the pelvic floor muscles and urinary sphincter. For Kegel exercises to work, you must do regularly.

A technique called biofeedback can be used in conjunction with Kegel exercises to do exercises that work better. Biofeedback involves the use of pressure sensors or electrical stimulation to the proper guidance of the muscle contractions. Once your muscles are strong, you can tighten these muscles before doing anything that would cause leaks to prevent leakage.

Medications

There is no medication approved for the treatment of stress urinary incontinence in the united States.

Stress urinary incontinence female

Devices

A vaginal pessary can help control stress urinary incontinence in people assigned female at birth. Urinary incontinence pessary has the shape of a ring with two bumps that are found on each side of the urethra.

Your health care professional can place this device for you. Helps support your urethra to prevent urine leakage during the activity. The pessary should be removed and cleaned regularly.

There are also vaginal inserts that look like tampons that can support your urethra. You can get the templates without the need of a prescription. These devices are a good option for people who do not want surgery. And the inserts can be discarded after use.

Surgery

The surgeries for the treatment of stress urinary incontinence are designed to help the sphincter closes, or for supporting the neck of the bladder. Surgical options for people assigned female at birth are:

  • Midurethral sling procedure.This is the most common procedure for stress urinary incontinence. It is a minimally invasive procedure in which is placed a small piece of mesh under the urethra, the tube. There have been press reports of problems with the use of mesh for vaginal prolapse repairs. But these mesh these procedures are safe and work. Your surgeon will explain the risks and benefits with the use of mesh with this type of surgery.
  • The neck of the bladder sling procedure. This procedure is normally used when people have stress urinary incontinence that is still occurring after a surgical procedure. This involves the use of a strip of tissue from the lower part of the abdomen or the thigh to make the sling. This procedure places the fascia in the neck of the bladder and uses an incision in the abdomen.
  • Agents of charge. Gels or other materials that can be injected into the tissues around the upper part of the urethra. These bulk materials to the area around the urethra.
  • The burch retropubic. This surgical procedure is used, sutures, called sutures, were joined by ligaments over the pubic bone. These sutures elevator and supporting tissues near the bladder neck and the upper part of the urethra. This surgery can be done through small cuts, called laparoscopic incisions, or by a larger incision in the abdomen.

Midurethral sling procedure. This is the most common procedure for stress urinary incontinence. It is a minimally invasive procedure in which is placed a small piece of mesh under the urethra, the tube.

There have been press reports of problems with the use of mesh for vaginal prolapse repairs. But these mesh these procedures are safe and work. Your surgeon will explain the risks and benefits with the use of mesh with this type of surgery.

Male stress urinary incontinence

The treatment for stress urinary incontinence in persons assigned male at birth may include:

  • Agents of charge. Gels or other materials that can be injected into the tissues around the upper portion of the urethra. These bulk materials to the area around the urethra.
  • Inflatable artificial sphincter.This device is placed in surgery. A cuff that is placed around the upper portion of the urethra. It does the work of the sphincter. Tubes connect the cuff to a balloon in the pelvis, which controls the pressure. A pump in the scrotum is controlled by the hand. Over time, the artificial sphincter may need an additional surgery to keep it working well.

Inflatable artificial sphincter. This device is placed in surgery. A cuff that is placed around the upper portion of the urethra. It does the work of the sphincter. Tubes connect the cuff to a balloon in the pelvis, which controls the pressure. A pump in the scrotum is controlled by the hand.

Over time, the artificial sphincter may need an additional surgery to keep it working well.

Lifestyle and home remedies

A healthy lifestyle can help alleviate symptoms of stress urinary incontinence. These include:

  • Shed the extra weight. If your body mass index (BMI) is 30 or higher, losing weight can help reduce the pressure on the bladder and the pelvic floor muscles. Even a 10% weight loss can significantly improve stress urinary incontinence. Talk with a member of your health care team to help with weight loss.
  • Add fiber to your diet. Having a hard time moving the bowls can add to urinary incontinence. To keep bowel movements soft and regular, relieves tension in the muscles of the pelvic floor. Try to eat foods rich in fiber to reduce and prevent constipation. Foods high in fiber include whole grains, legumes, fruits and vegetables.

Coping and support

Treatments for stress urinary incontinence, can often greatly reduce, and possibly stop, the leakage of urine. Some people still have loss of urine every now and then. Being prepared can help you cope.

Out and about

Stay connected to your family, friends and work colleagues that you do not feel alone and sad. Being prepared can help you feel better about being and about:

  • Stock up on supplies.Take enough incontinence protection pads or underwear, and, possibly, a change of clothes with you. Incontinence products are small. You can go on a roomy handbag or a small backpack. You can keep extra supplies and spare clothing in the trunk of your car or in a backpack for use when needed.
  • Know where you're going. Know where the restrooms are. Choose the seats that allows you to get to the bathroom easily.
  • Take good care of your skin. Time of contact with the wet clothing can cause sores on the skin. To keep the skin dry by the change of the wet clothes. The use of a protective cream if your skin is usually moist.

Stock up on supplies. Take enough incontinence protection pads or underwear, and, possibly, a change of clothes with you. Incontinence products are small. You can go on a roomy handbag or a small backpack.

You can keep extra supplies and spare clothing in the trunk of your car or in a backpack for use when needed.

Sex and incontinence

Urine leaks during sexual intercourse can be very annoying. But there are ways to avoid ruining sex for you.

  • Talk with your partner. This can be difficult to do, but tell your partner about your symptoms. A support partner and be willing to help can make your symptoms more manageable.
  • Empty your bladder before having sex. To reduce your chances of leakage, do not drink liquids for an hour or so before having sex. Empty your bladder before you start having sex.
  • Please try another position. Changing positions can make the brain less likely for you. For women, being on top might give you a better control of the muscles of the pelvis.
  • Do your Kegel exercises. These exercises strengthen the muscles of the pelvic floor and reduce urine leakage.
  • Be prepared. Have towels, hand or using pads disposable in your bed can ease your worry and to keep the leak.

Search help

Incontinence is not a normal part of aging. The treatments that can cure stress urinary incontinence or greatly reduce its effect on your life.

Find a health professional who will work with you to find the best way to treat urinary incontinence. You must work together to find the right treatment for you. Take the time to talk about the pros and cons of the many options of treatment.

You can join a support group. Support groups give you a place to talk about your concerns. And that can help you move forward with your self-care efforts.

Groups such as the National Association for Continence of the supply of resources and information for people who have stress urinary incontinence.

Preparing for your appointment

Your health care professional may have to fill out a form on stress incontinence symptoms. You can also ask to keep a journal of the bladder for a couple of days.

In a journal of the bladder, make a note of when, how much and what type of liquids that are consumed. Also keep in mind how much you urinate and when you have incontinence.

Your journal can show patterns that help your healthcare provider knows about your condition. This can reduce the need for some tests.

If you need special tests, you may be sent to a specialist in urinary diseases, which is called a urologist, or a specialist in urinary diseases, called a urogynecologist.

What you can do

To make the most of your appointment, take a family member or a friend with you to help you remember the information that is obtained.

Make a list of:

  • Their symptoms. Include when the urine leakage occurs.
  • Any medications, vitamins or supplements you take. Include the dose and how often you take the medicine.
  • Questions to ask your health care professional.

For urinary incontinence, some questions are:

  • My urinary incontinence worse?
  • Might pelvic floor exercises help me? How do I do this?
  • How does my weight affect my condition?
  • Could the medications that I take my condition worse?
  • What tests can I find the cause of my incontinence?
  • I'm going to need surgery?

Be sure to ask all the questions that you have.

What to expect from your health care professional

Be prepared to answer the questions of your health care professional, such as:

  • How often do you leak urine?
  • When leakage of urine, is a couple of drops or are your clothes soaked?
  • There are times when you know that you to escape?
  • Do you leak urine when you exercise?
  • Do you wake up during the night to urinate? What's the frequency?
  • How much do you drink each day?
  • Does anything seem to make their incontinence, better? What's worse?
  • What bothers you most about urinary incontinence?
  • Do you also have bowel leakage? What's the frequency? Does this cause you to restrict your activities?
  • It feels as if something falls outside the pelvis or in the vagina?
Symptoms and treatment of the stress urinary incontinence