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Stress urinary incontinence (SUI) is leakage of urine that comes from physical exertion. Activities like coughing, sneezing, laughing, lifting, or running can increase pressure or “stress” to the bladder and cause leakage.
SUI is fairly common and affects one out of three women over 45 years old.
Women most commonly develop SUI from changes that happen with pregnancy or childbirth, which weakens the support to the urethra, a tube that carries the urine out of the body. Other risk factors that may cause SUI are chronic coughing, repetitive heavy lifting, constipation, obesity, smoking, and aging.
Depending on the severity of the symptoms, women may limit physical and social activities to avoid SUI. There is no need to suffer in silence. There are treatment options available for this condition.
There are different kinds of urinary leakage. To diagnose SUI, a provider will ask when and how often leakage occurs. The provider will do a physical exam to evaluate the pelvic support. Additional testing may need to be done to assess bladder function.
The ideal treatment for SUI will depend on how severe the symptoms are and how bothersome they are. There are conservative treatments such a lifestyle changes, pelvic floor muscle exercises, or the use of a vaginal pessary. There are surgical options to give additional support to the urethra. There are no medicines that help this problem.
Below are some of the treatment options used to reduce stress urinary incontinence.
Pelvic floor muscle exercises (PFME), commonly known as “Kegel” exercises, can help strengthen the pelvic floor and improve symptoms. These are most helpful in mild to moderate SUI symptoms. PFME need to be done regularly, and it may take 3 to 6 month to see results. For the best effect, work with a specialized physical therapist.
A pessary is a silicone device that is inserted to the vagina. It is designed to give support behind the urethra and help it close. This will help control leakage when physical activity is done. Some women wear a pessary only when they exercise or during allergy season, while others leave it in all the time.
SUI surgery addresses the weakened urethral support with either a sling or suspension stitches.
The placement of a sling is the most common surgery done for SUI.
It uses either synthetic mesh or a biologic graft to give support to the urethra. The synthetic mesh slings are the most durable type of slings with a high success rate.
There are some modifications to one’s lifestyle that can reduce SUI symptoms:
If you suffer from stress urinary incontinence, there are options for you! A urogynecologist or female urologist will be able to discuss each of these options with you and help tailor the best treatment for your condition.
Dr. Andrea Crane is a board certified OB/GYN and urogynecologist at WakeMed with interests in comprehensive pelvic reconstruction, da Vinci® robot-assisted sacrocolpopexy, and sacral neuromodulation. Her training includes evaluation and treatment of childbirth trauma, advanced pelvic organ prolapse, urinary and fecal incontinence, vesicovaginal and rectovaginal fistulae, and mesh complications. Learn more about urogynecology in Raleigh, NC, and schedule an appointment today.
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Raleigh, NC 27610