Stress Urinary Incontinence
Stress urinary incontinence (SUI) is the loss of urine as a result of physical activities that increase abdominal pressure. These activities include sneezing, coughing, laughing and straining when performing exercises like abdominal crunches or lifting objects. This increase in abdominal pressure leads to an increase in the pressure within the bladder, which behaves like a balloon filled with liquid. The rise in bladder pressure then forces the urethra open and urine loss occurs. Urine loss with stress incontinence often feels like a squirt, which can be small or large depending upon the amount of liquid in the bladder at the time and the holding strength of your urethral muscle.
Common risk factors for stress incontinence include having had a vaginal delivery, previous pelvic surgery, radiation treatment to the pelvis, increased abdominal pressure due to respiratory conditions like chronic coughing, constipation, obesity, age and heavy lifting. In some cases there is also inherited weakness of the supportive connective tissue of the pelvis.
Surgery for stress urinary incontinence
Stress Urinary Incontinence is often well managed by non-invasive surgery. The most common type of surgery performed is an outpatient procedure done with only a few small incisions. Minimally invasive surgery means that you have a faster recovery time and fewer post-surgery restrictions.
You and your doctor will be able to discuss which surgery is best for you once you have had bladder testing to identify your specific urine loss problem.
Non surgical treatments for urinary incontinence
Many pelvic floor conditions will respond to treatments that don’t require surgery. But even if you and your doctor choose a surgical procedure, the long-term resolution of your disorder is often improved by these non surgical methods.
Kegel exercises
Building and maintaining strength in the muscle group that supports your bladder, vagina and rectum is important for overall pelvic floor health. With Kegel exercises, you build strength by pulling in or “squeezing” your Kegel muscles. These exercises are important in preventing and treating stress and urge urinary incontinence (involuntary leakage of urine), fecal incontinence (involuntary leakage of stool and gas) and pelvic organ prolapse (falling or bulging). You can do Kegel exercises on your own or with the help of a pelvic floor physical therapist. Learn more about kegels in our Urogynecology FAQ.
Biofeedback
This is a special way of performing Kegel exercises by using a device that gives you feedback about the strength and holding ability of your Kegel squeeze. You can do this at home or in a physical therapist’s office with the use of special equipment.
Behavioral modification
Several bladder and bowel conditions respond to behavioral changes. Certain foods and beverages can be irritating, especially to your bladder. It can also be easy to fall into habits over the long run, which can have a negative effect on how your bowel and bladder function. We will evaluate your day-to-day habits to see if you have any patterns that can be altered to improve your condition.
Medications
Most commonly, we use medication to treat conditions that result in increased urinary urgency and frequency. These medications mildly relax your bladder muscle so that you can hold more urine and therefore go to the bathroom less frequently. There are also medications available to help treat bladder pain.