Female Urinary Stress Incontinence
What is female urinary stress incontinence?
Female urinary stress incontinence is the involuntary release of urine during any physical activity that puts pressure on your bladder. It’s not the same as general urinary incontinence. This potentially irritating condition only occurs when the bladder is under immediate physical stress. Activities that can put stress on your bladder include:
- lifting or forcing heavy objects
- bending over
What causes female urinary stress incontinence?
Female urinary stress incontinence occurs when your pelvic muscles weaken. These muscles form a bowl that caters to the pelvis. They support your bladder and control the release of your urine. As we age, these pelvic muscles weaken. Childbirth, pelvic surgery, and damage to your pelvis can weaken your muscles. Increasing age and pregnancy history are also major risk factors.
Who develops urinary incontinence?
Stress incontinence is much more common among women than men. It can occur at any age. However, the likelihood of developing stress incontinence increases with pregnancy and with your age.
According to the American Academy of Physicians (AAP), about 50 percent of women ages 40 to 60 and about 75 percent of women over 75 have some form of urinary incontinence (UI). The actual figures may be even higher, as the condition has not been reported and diagnosed, according to the AAP. He estimates that about half of women who experience UI do not report it to their doctor.
Certain factors can increase the risk of female urinary stress incontinence or exacerbate symptoms, if any.
Food and drinks
The following may make stress incontinence worse due to bladder irritation:
- artificial sweeteners
- tobacco or cigarettes
The following health factors can make stress incontinence worse:
- urinary tract infections
- frequent cough
- drugs that increase urine production
- excessive urination from nerve damage or diabetes
Lack of treatment
Female urinary stress incontinence is usually treatable. But many women rarely seek help. Don’t let your embarrassment stop you from seeing your doctor. Female urinary stress incontinence is common. Your doctor has probably encountered it many times in other patients.
How is female urinary stress incontinence diagnosed?
To make a diagnosis, your doctor will likely do a pelvic exam in addition to one or more of the following tests:
- Urinary stress test: Your doctor will ask you to cough while you stop to see if there is incontinence.
- Pad test: You will be asked to wear a sanitary pad to see how much urine you leak during exercise.
- Urine test: This test allows your doctor to detect if there are certain abnormalities in the urine, such as blood, protein, sugar, or signs of infection.
- Post-void residual (PVR) test: Your doctor will measure how much urine is in your bladder after you emptied it.
- Cystometry test: This test measures the pressure in your bladder and your urine flow.
- X-ray with contrast dye: Your doctor will be able to detect abnormalities in your urinary tract.
- Cystoscopy: This test uses a camera to look inside the bladder for signs of inflammation, stones, or other abnormalities.
What treatment is available?
Several types of treatments are available. Treatment options include:
- lifestyle changes
- non-surgical treatments
- surgical treatment
Make regular trips to the toilet to reduce the risk of urine leakage. Your doctor may also recommend that you avoid caffeine and exercise regularly. Dietary changes may also be in order. If you smoke, it is recommended that you quit smoking. Losing weight can also help suppress your stomach, bladder, and pelvic organs. If you are overweight, your doctor may also develop a weight loss plan.
Your doctor may recommend medications that reduce bladder contractions. It includes such drugs as:
Your doctor may also recommend mediation designed to treat an overactive bladder:
Kegel exercises and pelvic floor muscle therapy
Kegel exercises can help strengthen your pelvic muscles. To do these exercises, tighten the muscles that stop the flow of urine. Your doctor will show you the right way to do these exercises. However, it is not clear how many Kegels should be done, how often, or even how effective they can be. Some research has shown that doing Kegel exercises during and after pregnancy can reduce your chances of developing urinary stress incontinence.
Pelvic floor muscle therapy is another effective method to help relieve stress incontinence. This can be done with the help of a physical therapist who is specifically trained in pelvic floor exercises. An increase in overall physical activity has been shown to strengthen the pelvic floor. Yoga and Pilates are known to be beneficial.
Biofeedback is a type of therapy used to increase awareness of your pelvic floor muscles. The therapy uses small sensors placed in or around your vagina and on your abdomen. Your doctor will have you try some muscle movements. Sensors record your muscle activity to help identify specific muscles in the pelvic floor. This can help identify exercises that help strengthen your pelvic floor and improve bladder function.
This procedure requires inserting a small ring inside your vagina. It will support your bladder and compress your urethra. Your doctor will fit you the right size vaginal muzzle and show you how to remove it for cleaning.
Your doctor may recommend surgery if other treatments fail. Types of surgery include:
Doctors inject a swelling agent into your urethra to thicken the area to reduce the risk of incontinence.
Tension-free vaginal tape (TVT)
Doctors place a mesh around your urethra to support it.
Doctors place a sling around the urethra to provide more support.
Anterior or paravaginal vaginal repair (also called cystocele repair)
This surgery repairs a bladder that has bulged into the vaginal canal.
This surgery returns the bladder and urethra to their normal position
Can I treat stress incontinence?
Stress incontinence is very common among women over 40. Available treatments include lifestyle changes, medications, nonsurgical treatments, and surgery. These treatments rarely cure stress incontinence. But it can reduce symptoms and improve quality of life.