Stress incontinence means some urine leaks out when you don't want it to when the bladder and urethra are under pressure. The leakage can be triggered by simple things like coughing, sneezing, laughing or lifting something heavy.
The leakage may be anything from a dribble to a full stream of wee.
Stress incontinence is one of the most common types of incontinence in women but can also affect men.
What causes stress incontinence?
Causes of stress incontinence include:
- The sphincter muscle that controls the urine flow at the neck of the bladder may not always be strong enough to hold back the flow
- Weak pelvic floor muscles that don't support the bladder well
- Pregnancy, with extra pressure on the bladder
- Nerve damage during labour
- Past operations, including C-section or hysterectomy in women and prostate operations in men
- Being obese or overweight
- Multiple sclerosis (MS), Parkinson's disease and other neurological conditions
- Ehlers-Danlos syndrome and connective tissue conditions
- Family history of urinary incontinence
- Being older
- Urinary tract infections (UTIs)
- Some medications, including diuretics (water tablets) that increase urine production.
Seek medical advice for stress incontinence. A doctor will make a diagnosis based on the symptoms, medical history and a physical examination. Urine tests will usually be arranged to check for urinary tract infections.
A referral may be made to a specialist or continence nurse or clinic.
How is stress incontinence treated?
Stress incontinence symptoms may be helped with:
- Pelvic floor exercises, to strengthen the muscles supporting the bladder to help reduce leakages.
- Absorbent pads to trap any leaks.
Medical treatments include:
- Medication: Duloxetine tablets may be recommended for women with stress incontinence if pelvic floor exercises haven’t helped.
- Bulking agent injections thicken the wall of the urethra to help it stay closed.
Surgical treatments include:
- Colposuspension: This surgical procedure lifts the neck of the bladder
- Tape procedure: Special tape is used in a surgical procedure to better support the urethra
- Sling procedure: This surgical procedure involves fitting a special sling to better support the neck of the bladder
- Artificial urinary sphincters: A fluid-filled cuff is implanted around the urethra in a surgical procedure and this artificial sphincter can be opened or closed manually when the man or woman needs to wee.