Stress Urinary Incontinence

Stress Urinary Incontinence is an involuntary loss of urine that accompanies any action that suddenly increases pressure in the abdomen. It is more common in women than men and it is the most common type of incontinence in older women. Severe leakage affects about one in ten women. More than half of women with symptoms don’t seek medical care.

Some women have the false belief that it is a normal part of aging. They think it cannot be treated but often times it can be.

In normal urination (voiding), the muscles around the urethra relax and the bladder contracts and urine flows out of the urethra and out of the body. When the bladder is almost empty the muscles around the urethra contract and stops the flow of urine. The bladder then relaxes.

There are five types of urinary incontinence. 

  • stress
  • urge
  • mixed
  • overflow
  • functional

Stress incontinence is the most common in younger women and occurs when the pressure in the bladder is greater than the pressure in the urethra. This causes the loss of urine when a woman coughs, laughs or sneezes. Leaks may also occur when a woman is walking, running or performing aerobics.

It is caused by the tissue supporting the bladder getting weak or the muscles of the urethra getting weak. These changes occur during pregnancy and after childbirth, particularly repeated childbirth. Obesity is also a factor. They may also occur as a natural consequence of aging.

Urge incontinence is when a woman has a sudden urge to void and leaks urine before she has time to get to them bathroom. It is often referred to an “overactive bladder” and occurs if the muscles to the bladder are too active and contract too often. This leads to leakage of urine and may also involve the nerve that sends messages to the bladder.

Mixed incontinence occurs when a woman has both stress and urge incontinence symptoms. This combination may cause more urine to leak than either type alone.

Overflow incontinence occurs when the bladder does not empty all the way during voiding. It can occur when the bladder muscle is not active enough or when the urethra is blocked. This usually allows for steady leaks of small amounts of urine.

Functional incontinence is when incontinence happens due to other health problems which keep a woman from getting to the toilet like arthritis, stroke, nervous system disorders or mobility problems.

Urodynamics testing is used for diagnosis of the cause of urinary incontinence. It measures the pressure and volume of the bladder as it fills and the flow rate as it empties. This evaluation can be done in our office. It is used to decide which therapy is best for you. Urinary incontinence can often be treated with a simple medication or a simple surgical outpatient procedure “tacking” the bladder up via a tiny discrete incision near the vaginal opening called a TVT-O. If you have any further questions or desire evaluation for this procedure please make an appointment to speak with one of our doctors.