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Stress Urinary Incontinence

  What is Stress Urinary Incontinence

Stress Urinary Incontinence Stress incontinence is not related to psychological stress but is an involuntary loss of urine caused by a physical movement or activity that results in increased pressure (stress) being placed on the bladder, not only can physical exercise, lifting or bending cause leakage but also everyday tasks such as getting up from a seat or sitting down can also result in leakage sneezing and coughing can also have the same effect

Like a balloon being filled with water the bladder expands as it fills with urine. Urine exits the body via a tube connected to the bladder known as the urethra .To prevent urine flowing out from the bladder until you wish to void there are two groups of muscles known as urinary sphincters these muscles stay contracted to stop urine passing until a signal is received from the brain allowing them to relax and urine to flow. Also supporting the bladder is another group of muscles known as pelvic floor muscles.

Normally these groups of powerful muscles can withstand very high and sudden increase in bladder pressure before leak off pressure is reached in the case of Stress incontinence due to a weakening of these muscles leak off pressure is much lower and even a relatively small increase in bladder pressure can result in involuntary leakage. This can involve one or both of the both muscle groups.

 

What causes Urinary Incontinence

Stress Incontinence can occur in women for the following reasons

During Pregnancy-  Pelvic floor or urethral sphincter muscles groups may become fatigued and weakening because of the extra weight

Childbirth- During childbirth muscle tearing or nerve damage may occur resulting in poor function of pelvic floor muscles or the urinary sphincter.  Stress incontinence may be present soon after childbirth or occur many years later.

Hysterectomy- may have an adverse effect on the muscles supporting the bladder and urethra, increasing the risk of stress incontinence developing. This may occur immediately or later on in life.

 

There are a number of factors that make you more likely to develop stress incontinence

Ageing- as you get older your muscles may lose some of their tone and become weaker although stress incontinence should not be considered  a natural part of the ageing process

Smoking – can be the cause of a persistent cough which puts undue pressure on the bladder

Overweight- Being overweight increases the resting pressure on your bladder and pelvic floor muscles in addition to an increase in  pressure from a cough or other force this may be enough to overcome the muscles stopping urine leaking from the bladder.

 

For men the main cause of stress incontinence is

Prostate Surgery-Men who have undergone prostate surgery can also develop stress incontinence as a result of the urethral sphincter muscle being damaged when the prostate is removed.

 

What are the symptoms of stress incontinence

Mild incontinence- can be classed as light leakage occurring during vigorous activity such as running or playing tennis etc.

Moderate/ Severe incontinence can be classed when leakage occurs as above but also during movements such as standing up, walking, or bending over.

 

What treatments are available for stress incontinence

Treatments designed to combat urinary stress incontinence all have the same goal of improving the performance of the muscle groups that support the bladder (pelvic floor muscle) or the contraction of urethra valves (sphincter muscles) this is why you may be offered a combination of different treatments.

Lifestyle changes

Quitting smoking and losing weight will help alleviate the impact stress incontinence has on your everyday life

Pelvic floor muscle training and Biofeedback

Carrying out a specific set of exercises designed to target and strengthen the muscles that help support the bladder and can have significant impact on restoring continence Pelvic floor (Kegel) exercises are designed to strengthen some of the muscles

These exercises are very simple and can be done anywhere without anybody being aware. So you can exercise as often as you like where ever you want.

 

Simple pelvic floor exercises:

Using the same muscles in your abdomen and buttocks relaxed.

Try to maintain the squeeze for 3 seconds, then relax for 3 seconds.

Repeat the exercise 10 to 15 times as often as you can each day

 

To be effective as with all exercise, pelvic floor exercises need a high level of motivation and need to be done regularly everyday.

By attaching probes to measure bladder rectal and abdominal pressures you will be able to watch on screen how these different groups of muscles work, by watching this information you will be able to learn how to relax your bladder and abdominal muscles while contracting your pelvic floor muscles. This is known as Biofeedback together with Pelvic floor exercises this can result in a marked decrease or even total stopping of urinary incontinence.

To find out more about Pelvic floor exercise and Biofeedback

 

Absorbent Pads

The use of incontinence pads from time to time may be beneficial, as an extra safeguard against leakage to allow you to go about your day to day life with confidence. They may also be helpful  during bladder retraining or in situations where pressure  on the bladder increases ie going to the gym or out for a run

 

Surgery

If Urinary stress incontinence fails to respond to after conservative options then there are many forms of surgery which may help many of which are minimally invasive

Urethral bulking implants

 

Bladder neck suspension

Vaginal Sling

TVT Tension free vaginal tape

Artificial urinary sphincter

Male Sling

 

 

The information contained within this website has been provided as a general guide and should not be treated as a substitute for the medical advice of your own GP or any other health professional.