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Stress Incontinence Symptoms
Small amounts of urine leaking when you laugh, sneeze, cough, or exercise
The anxiety that fears of sudden urine leakage can cause sometimes leads people to avoid physical activity, reduce social participation, or even limit travel for fear of accidents. Over time, feelings of embarrassment and reduced self-confidence can make simple activities, like laughing with friends, enjoying exercise classes, or lifting a child become stressful rather than joyful.
Some people experience leakage only during high-impact activities (e.g., running), while others may suffer from severe stress incontinence that causes urine leakage from mild movements, such as simply standing up.
Contributing Factors to Stress Urinary Incontinence
Conditions like Parkinson’s disease, multiple sclerosis, or stroke can disrupt nerve signals to the bladder muscle, causing leakage.
An overactive bladder detrusor muscle contracts unexpectedly, contributing to leakage episodes.
Certain drugs, including diuretics, can exacerbate urinary incontinence symptoms.
Substances such as caffeine, alcohol, and spicy foods can aggravate urinary symptoms.
Risk Factors
Vaginal deliveries frequently stretch or weaken pelvic structures, increasing the risk of female urinary incontinence.
Reduced estrogen levels can weaken the urethral support structures, making women more susceptible to leakage.
Men may develop stress urinary incontinence after prostate surgery, as surgical changes can weaken sphincter control.
Excess body weight places additional pressure on the bladder and pelvic structures.
Conditions like smoking-related cough or bronchitis strain the pelvic floor.
Procedures such as hysterectomy or prostate surgery can compromise pelvic floor integrity.
Investigations to Diagnose Stress Urinary Incontinence
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Evaluate symptoms, review lifestyle, check pelvic floor integrity.
To rule out urinary tract infection or other underlying conditions.
Bladder Diary: Record of fluid intake, urination times or patterns, and urine volumes.
Urodynamic Testing: Measures bladder pressure and urine flow.
Cytoscopy: Visual inspection to rule out anatomical abnormalities.
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Management
Managing weight, moderating fluid intake, and quitting smoking can notably improve symptoms.
Physical Therapy: Biofeedback or electrical stimulation to enhance pelvic floor muscle tone.
Pelvic Floor Exercises: Regular pelvic floor muscle training (pelvic floor exercises or Kegel exercises) can improve bladder control.
Bladder training: Techniques to gradually increase intervals between bathroom visits, reducing urgency and leakage.
Mid-Urethral Sling: A minimally invasive procedure to treat stress incontinence where a narrow synthetic mesh tape is placed under the urethra to provide support and reduce urine leakage. This procedure uses a type of mesh that has been extensively studied and is commonly used in Canada.
Bladder Neck Suspension: An operation that elevates and secures the bladder neck to prevent stress-related urine leakage. More often used in women who have not responded to less invasive options.
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