|AGE More common with increasing age||GENDER Almost exclusively affects females|
|LIFESTYLE Not significant factors||GENETICS Not significant factors|
Stress incontinence is the involuntary loss of urine during exertion, coughing, or sneezing.
Stress incontinence results from weakness of the urethra (the tube from the bladder to the outside of the body) and pelvic floor muscles. These muscles support the bladder and help to control the opening and closing of the bladder outlet when passing urine. Weakness of the muscles allows the bladder neck to drop. Involuntary loss of urine occurs when pressure in the abdomen is increased.
In mild stress incontinence, a small amount of urine leaks out of the bladder during strenuous activities, such as running. In severe cases, urine escapes during activities that cause increased pressure on the bladder, such as coughing or lifting. Stress incontinence is the most common type of incontinence and mostly affects women.
The disorder commonly occurs during and after pregnancy; after surgery in the pelvic area; during the menopause, when a reduced level of the hormone oestrogen causes the pelvic muscles to lose elasticity; and with increasing age. Stress incontinence may also be linked to a prolapse of the uterus and vagina, rectal prolapse, or a prolapsed bladder. The condition is more likely to develop if you have a persistent cough. Rarely, men develop stress incontinence after prostate surgery.
How is stress incontinence diagnosed?
Your doctor may diagnose stress incontinence after asking about your fluid intake, how often you pass urine, the amount of urine you pass, and when you leak urine. He or she will perform a pelvic examination to check your pelvic floor muscles and find out if you have a prolapsed uterus. The doctor may refer you to hospital for urodynamic studies to assess your bladder function.
What is the treatment?
Strengthening the pelvic floor muscles with pelvic floor exercises is an effective form of self-help treatment for stress incontinence, whatever the cause. If the condition occurs after childbirth, muscle tone will gradually return, but the exercises, which help to strengthen the muscles supporting the bladder, may speed recovery. If you are overweight, your doctor may recommend a diet to help you to lose weight (see Controlling your weight). In severe cases of stress incontinence, surgery to reposition the bladder and improve its support may be needed and may restore near-normal bladder control.
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