Stress Incontinence: Causes & Symptoms

Medically Reviewed by Dr Sravya, MBBS, MS

Introduction

One out of every four women suffers from urinary incontinence and is ashamed to discuss it with their friends, families, and doctors, even though it is a common condition.

In This Article

What is urinary incontinence?

Urinary incontinence is a medical condition where there is a loss of bladder control. As a result, you may leak a small amount of urine or release a lot of urine in one go. Urinary incontinence is more commonly seen in women.

This blog will focus on understanding the urinary system and the causes and symptoms of stress incontinence.

Understanding the parts of the Urinary System

Let us first understand the parts and functions of the urinary system.
The urinary system has two kidneys that make urine by filtering the waste out of the blood. The urine then passes through the urinary tracts on both sides and gets stored in the bladder.
When the bladder is full, its muscles contract, and the urine passes out of the urethra. Sphincter muscles control the opening of the bladder.

Types of Urinary Incontinence

There are three types of urinary incontinence, depending on their causes.

Stress Urinary Incontinence (SUI)
The muscles of the pelvic region support the bladder and other parts of the urinary system. When the pelvic muscles are weak, the bladder has to work harder to hold the urine in. Extra pressure on the bladder due to laughing, coughing, sneezing, exercising, etc., may cause urine leakage. SUI may also happen when the muscles of the bladder tighten but the sphincter muscles are weak.
Urge Urinary Incontinence
This happens when there is an uncontrollable, sudden urge to pass urine.
Mixed Urinary Incontinence
Many women experience both stress and urge urinary incontinence.

Stress Urinary Incontinence

Pregnancy, childbirth, and menopause are health events that are unique to women. These events may weaken or damage the pelvic floor muscles in some cases.

In that scenario, the urinary bladder has to work extra hard to hold the urine in. But sudden actions like sneezing, coughing, or physical activities like exercising and dancing may cause pressure on the bladder and leakage of urine. This condition is known as Stress Incontinence.

It is not a disease by itself but a symptom of weak pelvic floor or sphincter muscles.
It is the most common type of incontinence and is usually seen in younger women.

What are the causes of Stress Incontinence in women?

The underlying cause of urinary incontinence is weakened muscles of the pelvic floor and sphincter or conditions causing extra pressure on the pelvic floor.

Causes that weaken the muscles of the pelvic floor and urethral sphincter:

(i) Pregnancy and vaginal delivery stretch the pelvic floor muscles and may weaken or damage them, leading to incontinence in later years.
(ii) The symptoms go away as the muscles heal after childbirth.
(iii) It would be a good idea to talk to your doctor if the problem continues even after 6 weeks of childbirth.

Causes exerting extra pressure on the pelvic floor muscles

What are the symptoms of Stress Incontinence?

Involuntary urine leakage due to sudden movements like coughing or sneezing or activities like exercising, dancing, or lifting heavy weights due to extra pressure on the abdomen is the only symptom of SUI.
It is important to note that in Urge Urinary Incontinence, there is a sudden strong urge to urinate followed by leakage.

How is Stress Urinary Incontinence treated?

If you have SUI and your symptoms are bothering you, please consult a gynecologist. In most cases, the doctor will start with nonsurgical treatments.

Nonsurgical Treatments

(i) Limit your caffeine intake and quit smoking. They are known to irritate the bladder and increase the need to urinate.

(ii) Schedule regular bathroom breaks to avoid accidental leakage.

(iii) Since obesity is one of the causes of SUI, try to reach your optimum weight by following a healthy diet and regular exercise.

(i) Doctors recommend Kegel exercises to strengthen the pelvic floor muscles in both men and women with urinary incontinence, or even as a preventive method.

(ii) To find the right muscles to exercise, pretend that you have to pass urine and then hold it. You will feel the muscles tightening in your vagina, bladder, and anus. These are the pelvic floor muscles. If you feel them tighten, you have done the exercise correctly. Your thighs, hip muscles, and abdomen should remain relaxed.

(iii) While exercising, make sure your bladder is empty.

(iv) Alternately tighten and relax the muscles for 3 to 5 seconds and repeat this 10 times.

(v) You can do this three times daily while watching TV, driving, sitting, or lying down.

(vi) It takes 4-6 weeks of regular exercise to show results.

(vii) You must make it a part of your life, as incontinence may return if you stop.

(i) A pessary is a small ring-like device made of plastic or silicone.

(ii) When placed in the vagina, it pushes against the walls of the vagina and the urethra to support the pelvic floor muscles. This helps reduce stress incontinence.

(iii) Your doctor will recommend a suitable size for you. They are easily available.

Surgery

If the nonsurgical methods fail to help and you are not planning another pregnancy, your doctor may suggest a surgical procedure for urinary incontinence.

Types of surgery for urinary incontinence include:

(i) The tissues around the bladder and urethra thicken when collagen is injected into them.

(ii) This puts pressure on the urethra and keeps it closed, thereby reducing leakage.

(iii) It is a simple procedure that can be done in the clinic.

(i) This is the most common type of surgery to treat SUI.

(ii) The doctor will use a sling made of either synthetic mesh or tissue from your own body and place it under your urethra. This supports the urethra and holds the bladder in place.

(iii) However, some women have reported complications like pain, infection, pain during sex, and damage to the bladder. Please remember to ask your doctor about the possible side effects.

(i) In this surgery, the bladder is placed with stitches on both sides of the urethra.

Conclusion

Most women accept urinary incontinence as a part of childbirth and old age. They start to avoid certain activities to prevent accidental urine leakage. They always have to be alert for any mishaps at work or socializing. They are too embarrassed to talk to their families, friends, or a doctor about what they are going through. This can lead to a lot of mental anxiety and stress.

But now that you know how common SUI is, it would be a good idea to consult your doctor.

Talk to the older women in your family about it. You never know; your mother or mother-in-law may have silently endured a leaky bladder for years. You will get their blessings, and you can thank us later!