Stress incontinence is a form of urinary incontinence and occurs when you pass urine unintentionally. Stress incontinence is not related to feeling stressed; it occurs when the bladder is put under sudden extra pressure (or ‘stress’). This pressure can be caused by simple activities such as sneezing, laughing, coughing or exercising. Factors such as age, weight, and being pregnant all heavily influence stress incontinence. Although a potentially embarrassing condition, stress incontinence is quite common and can be treated with pelvic exercise.
Stress incontinence is the most common form of urinary incontinence. Approximately three million women in the UK are regularly incontinent. Overall, 4% of adults in the UK are estimated to be incontinent, and stress incontinence is the cause for over half these cases.
Stress incontinence is more common in older women due to its heavy links to childbirth. Around one in five women over the age of 40 have some level of stress incontinence.
In reality, the figure is probably higher. Many people are embarrassed by stress incontinence. They refrain from informing their GP in the hope that the condition will pass. Often stress incontinence can be treated, which is why informing your GP of the condition is very important.
What causes stress incontinence?
Urine leaves your body through a tube called the urethra. Stress incontinence occurs when the pressure of the urine within the bladder overwhelms the ability of your urethra to stay closed. Weak or damaged pelvic floor muscles, or a damaged urethral sphincter (the muscle that controls the urethra), are the most common causes of stress incontinence.
Certain factors increase the likelihood of stress incontinence – generally by weakening or damaging your pelvic floor muscles and/or urethral tract. These include:
- Being overweight: excessive weight creates pressure on the bladder
- Age: muscles like the pelvic floor and urethral sphincter weaken with age
- Pregnancy: the unborn baby can press against the abdomen
- Childbirth: especially a vaginal birth, which can damage the pelvic floor muscles
- Menopause: a shortage of oestrogen can weaken the pelvic floor and urethral sphincter
- Operation in pelvic area: prostate surgery is a common cause for men, and hysterectomy for women
- Heavy and persistent cough
Pelvic Muscle Exercise
Stress incontinence can be treated. The most simple and successful treatment involves exercising your pelvic muscles. Exercise strengthens your pelvic muscles and thus reduces susception to incontinence. Around 60% of stress incontinence cases can be cured or vastly improved by pelvic exercise.
Medicines and surgery are both options if the pelvic exercise have no effect.
Duloxetine is a medication that can help strengthen bladder muscles. It must be ingested orally twice a day.
Surgical options include:
- Tension-free vaginal tape: for women only. Plastic tape is inserted between the vagina and urethra. The tape supports the urethra and should stop leaks
- Sling procedures: suitable for both genders, although more common for women. A sling is placed around the neck of the bladder to support it and prevent leaks
- Artificial urinary sphincter: more commonly used for men. An artificial urinary sphincter replaces the original organ
- Colposuspension: women only. The front wall of the vagina is lifted and stitched onto a ligament behind the pubic bone
Always seek treatment for stress incontinence. Your GP will have encountered the condition many times before and can help arrange the treatment that is right for you.