Stress Urinary Incontinence
Urinary incontinence is the unintentional loss of urine. Stress incontinence happens when physical movement or activity — such as coughing, laughing, sneezing, running or heavy lifting — puts pressure (stress) on your bladder, causing you to leak urine. Stress incontinence is not related to psychological stress.
If you have stress incontinence, you may feel embarrassed, isolate yourself, or limit your work and social life. You may also avoid physical and leisure activities. With treatment, you’ll likely be able to manage stress incontinence and improve your overall well-being.
If you have stress incontinence, you may feel embarrassed, isolate yourself, or limit your work and social life. You may also avoid physical and leisure activities. With treatment, you’ll likely be able to manage stress incontinence and improve your overall well-being.
Symptoms
If you have stress incontinence, you may leak urine when you:
- Cough or sneeze
- Laugh
- Bend over
- Lift something heavy
- Exercise
- Have sex
Diagnosis
During your visit, your doctor looks for clues that may indicate contributing factors. Your appointment will likely include a:
- Medical history
- Physical exam, which may include a rectal exam and a pelvic exam in women
- Urine sample to test for infection, traces of blood or other abnormalities
- Brief neurological exam to identify any pelvic nerve problems
- Urinary stress test, in which the doctor observes urine loss when you cough or bear down
- Have sex
Treatment- Your doctor may recommend a combination of strategies to treat incontinence. If an underlying cause or contributing factor, such as a urinary tract infection, is identified, you’ll also receive treatment for the condition.
Surgery
Surgical interventions to treat stress incontinence are designed to improve closure of the sphincter or support the bladder neck. Surgical options include:
- Sling procedure. This is the most common procedure performed in women with stress urinary incontinence. In this procedure, the surgeon uses the person's own tissue, synthetic material (mesh), or animal or donor tissue to create a sling or hammock that supports the urethra. Slings are also used for men with mild stress incontinence. The technique may ease symptoms of stress incontinence in some men.
- Injectable bulking agents. Synthetic polysaccharides or gels may be injected into tissues around the upper portion of the urethra. These materials bulk up the area around the urethra, improving the closing ability of the sphincter.
- Retropubic colposuspension. This surgical procedure uses sutures attached to ligaments along the pubic bone to lift and support tissues near the bladder neck and upper portion of the urethra. This surgery can be done laparoscopically or by an incision in the abdomen.
- Inflatable artificial sphincter. This surgically implanted device is used to treat men. A cuff, which fits around the upper portion of the urethra, replaces the function of the sphincter. Tubes connect the cuff to a pressure-regulating balloon in the pelvic region and a manually operated pump in the scrotum.