Introduction

If you often leak urine when you sneeze, laugh, or exercise, you probably have a condition called stress incontinence. Many women get this problem, especially after they've had a child. Stress incontinence can be uncomfortable and embarrassing, but there are treatments that work well.

We've brought together the best research about stress incontinence and weighed up the evidence about how to treat it. You can use our information to talk to your doctor and decide which treatments are best for you.

If you leak urine when you cough, sneeze, exercise, or laugh, you probably have stress incontinence. Many women get this problem, especially after they've had children.

You may think you just have to put up with this problem. You may even feel too embarrassed to go to your doctor. But there are many treatments for stress incontinence that work well.

If you have stress incontinence, the muscles that keep your bladder closed are weak. Things like sneezing and coughing put extra pressure on the muscles and urine leaks out. You can strengthen these muscles by doing special exercises called pelvic floor exercises (also called Kegel exercises).

Key points about stress incontinence

• Stress incontinence is common. About half of women get it at some time in their lives.

• You're most likely to get stress incontinence after you've had a baby, and it can get worse as you get older.

• If you're bothered by your stress incontinence you should see your doctor. Treatment can help no matter how long you've had the problem.

• Pelvic floor exercises are the main treatment. They're safe and they work.

• Doctors can prescribe a drug treatment for stress incontinence. It's called duloxetine (brand name Yentreve).

• If your incontinence is bad, you may need surgery.

How things normally work

To understand stress incontinence, it helps to know about the parts of your body that make, carry, and store urine.

• Your kidneys make urine. They're in the middle of your back, on either side of your spine. They take out waste and excess fluid from your blood. This becomes urine.

• From your kidneys, urine flows down two tubes (one on each side of your body) called ureters and into your bladder.

• Your bladder stores urine. It's a muscular bag, a bit like a balloon. It reacts to signals from your brain sent through your nervous system. When your bladder squeezes or tightens (contracts), urine is forced out.

• From your bladder, urine flows out through a tube called the urethra and out of your body.

• A ring of muscle called the urethral sphincter sits at the bottom of your bladder. This works like a valve. When it opens, urine flows out of your bladder. When it closes, it helps to hold urine in your bladder.

• Underneath your bladder are your pelvic floor muscles. They're important because they support your bladder and help it hold in urine.