Many individuals both male and female experience stress incontinence, but are often too embarrassed to mention this to their doctor and spend many years without any form of treatment. With the correct treatment many persons can manage stress incontinence. Stress incontinence can often interfere with the normal activities of life.
What is stress incontinence?
Urinary incontinence is the unintentional loss of urine. Stress incontinence is prompted by a physical movement or activity — such as coughing, sneezing, running or heavy lifting — that puts pressure (stress) on your bladder and results in the leakage of urine. Stress incontinence is not related to psychological stress.
Stress incontinence is also different from urge incontinence, which is the unintentional loss of urine caused by the bladder muscle contracting, usually associated with a sense of urgency.
How common is stress incontinence?
Stress incontinence is the most common type of incontinence suffered by women, especially older women. In addition, women who have given birth are more likely to have stress incontinence. Stress incontinence can also occur in men as well.
How do you know if you have stress incontinence?
Most individuals are aware that they have a problem with their urine.The main symptom of stress incontinence is a leakage of urine at times of physical movement or activity. Individuals with stress incontinence will experience urine leakage when they do the following:
• Cough
• Sneeze
• Laugh
• Stand up
• Lift something heavy
• Exercise
• Have sexual relations
Why do you get stress incontinence?
Stress incontinence occurs because of diminished function in the bladder control muscles that regulate the release of urine.
Your urinary sphincter and pelvic floor muscles may lose strength because of:
• Childbirth. This frequently occurs after a normal vaginal delivery, but in most cases it can be corrected with strengthening of pelvic floor muscles. Stress incontinence from this damage may begin soon after delivery or occur years later.
• Prostate surgery. In men, the most common factor leading to stress incontinence is the surgical removal of the prostate gland (prostatectomy) to treat prostate cancer.
A number of factors can worsen stress incontinence. They include the following:
• Illnesses that cause chronic coughing or sneezing
• Obesity
• Smoking, which can cause frequent coughing
• Excess consumption of caffeine or alcohol
• Hormonal deficiency
Diagnosis
If you have symptoms suggestive of stress incontinence you should see your doctor. After a complete history and physical examination some tests might be required. The tests will vary from one individual to another. Special tests might be needed in a few complicated cases. Special testing is not necessary in most women with uncomplicated stress urinary incontinence – or in those who have not had prior surgery, pelvic radiation, spinal cord disease or advanced diabetes.
Treatment
Once a diagnosis is made and confirmed your doctor will likely recommend a combination of treatment strategies to end or lessen the number of incontinence episodes. If an underlying cause or contributing factor, such as a urinary tract infection, is identified, you will also receive treatments for those conditions.
Pelvic floor muscles exercises are often recommended in the vast majority of cases with uncomplicated stress incontinence. Kegel exercises are most important in preventing and treating urinary incontinence. These exercises strengthen your pelvic floor muscles and urinary sphincter. Your doctor or a physical therapist can help you learn how to do them correctly. Just like any other exercise routine, how well Kegel exercises work for you depends on whether you perform them regularly.
Your doctor will discuss a variety of other treatment options for stress incontinence. When other methods do not work, surgery may be an option.
Treatments for stress incontinence can usually substantially reduce, if not eliminate, urinary leakage and help you regain control of your bladder.
Conclusion
Stress incontinence is never normal regardless of your age. If you have symptoms of stress incontinence you should see a doctor who is willing to work with you to help reduce or eliminate them. There are a number of lifestyle changes that you might need to do as well such as losing weight and stop smoking. The good news is that you do not have to live with the symptoms of stress incontinence forever.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty years in clinical practice. Dr Hodge has a medical practice in the Johnson Building in The Valley.
