Urinary incontinence is the unintentional loss of urine. Stress incontinence is prompted by a physical movement or activity — such as coughing, sneezing or heavy lifting — that puts pressure (stress) on your bladder. Stress incontinence is not related to psychological stress.
Stress incontinence is much more common in women.
If you have stress incontinence, you may feel embarrassed, isolate yourself, or limit your work and social life, especially exercise and leisure activities. With treatment, you'll likely be able to manage stress incontinence and improve your overall well-being.
If you have stress incontinence, you may experience urine leakage when you:
You may not experience incontinence every time you do one of these things, but any pressure-increasing activity can make you more vulnerable to unintentional urine loss, particularly when your bladder is full.
When to see a doctor
Stress incontinence occurs because of poor function in the muscles that support the bladder or control the release of urine. Sometimes both muscle groups are involved. The bladder expands as it fills with urine, but valve-like muscles at each end of the urethra — the short tube through which urine flows to exit your body — normally stay closed, or contracted, preventing urine release until you reach a bathroom. When the muscles supporting the bladder are weak, however, pressure can trigger urine release before you're ready. Problems with the valves themselves (the urinary sphincters) may have the same effect.
Your bladder may not even feel unusually full when you have urine leakage due to stress incontinence. Anything that exerts force on the abdominal muscles — sneezing, bending over, lifting, laughing hard — also puts pressure on your bladder.
Your urinary sphincter and pelvic floor muscles may lose tone because of:
Female urinary system
Your bladder stores urine produced by your kidneys and expels it through a tube called the urethra. In women, the urethral opening is above the vagina. ...
Male urinary system
Your bladder stores urine produced by your kidneys and expels it through a tube called the urethra. In men, the urethral opening is at the tip of the penis. ...
Pelvic floor muscles
Your urinary sphincter, with the help of surrounding pelvic floor muscles, controls urine release from your bladder. Keeping these muscles well toned may help prevent or alleviate incontinence. ...
Factors that increase the risk of developing stress incontinence include the following:
Complications of stress incontinence may include:
Preparing for your appointment
Your doctor may use a questionnaire to make a preliminary assessment of your stress incontinence symptoms. You may also be asked to keep a voiding diary for a few days. You'll record when, how much and what kind of fluids you consume, as well as when you urinate and when you experience incontinence. Your diary may reveal patterns that help your doctor understand symptoms and identify contributing factors.
Specialized testing may require referral to a specialist in urinary disorders (urologist) or urinary disorders in women (urologist or urogynecologist).
What you can do
For urinary incontinence, some basic questions to ask your doctor include:
Make sure that you understand everything your doctor tells you. Don't hesitate to ask your doctor to repeat information or to ask follow-up questions for clarification.
What to expect from your doctor
Tests and diagnosis
During a basic diagnostic work-up, your doctor looks for clues that may also indicate contributing factors. The exam will likely include:
You and your doctor can review the results of these tests and decide on a treatment strategy.
Treatments and drugs
Your doctor is likely to recommend a combination of treatment strategies to end or lessen the number of incontinence episodes. If an underlying cause or contributing factor, such as a urinary tract infection, is identified, you'll also receive treatments to address those conditions.
Pessaries come in many shapes and sizes. The device fits into your vagina and provides support to vaginal tissues displaced by pelvic organ prolapse. Your doctor can fit you for a pessary and help ...
Lifestyle and home remedies
Healthy lifestyle practices can go a long way toward easing symptoms of stress incontinence.
Coping and support
Treatments today for stress incontinence can usually substantially reduce, if not eliminate, urinary leakage and help you regain control of your bladder. Still, you may need to cope with the effects of incontinence while waiting for surgery or for medication or behavior therapies to gain effectiveness.
Going out and about
Sexuality and incontinence
You might also consider joining a support group. Organizations such as the National Association for Continence (NAFC) can provide you with resources and information about people who experience stress incontinence. Support groups offer a venue for voicing concerns and often provide motivation to maintain self-care strategies.
Last Updated: 2010-10-16
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