What is stress incontinence?
This is the term given to passing urine involuntarily on exertion. Stress incontinence is more common in women than in men, and the incidence increases with age. It's caused by the muscles at the bottom of the bladder not staying closed around the urethra (the tube that carries urine out of your body). This is usually either because of a weakened pelvic floor (the sling of muscles that supports your pelvic organs) or damage to the urethra itself.
Because of the impact of pregnancy on the pelvic floor and the possibility of nerve damage to the urethra during childbirth, stress incontinence is particularly common in expectant and new mums. Other causes include obesity; a problem with the tissues supporting your bladder; taking certain medications; and a lack of the hormone oestrogen, levels of which drop dramatically with the menopause. There's also thought to be a genetic factor to stress incontinence.
What are the symptoms of Stress incontinence?
The only symptom is urine escaping on any exertion, whether through lifting something heavy or coughing, sneezing, laughing or exercise.
What are the treatments and remedies of Stress incontinence?
The first step towards overcoming stress incontinence usually involves making lifestyle changes , and your doctor will first talk to you about exercising your pelvic floor muscles. These exercises are easy to do and can be practised any time, anywhere. Repeating them regularly throughout the day should help you to regain muscle tone.
You might be advised to cut down on caffeine, which is a diuretic, meaning it encourages the body to produce urine. You'll probably also discuss how much water you drink a day, as drinking too little can irritate the urinary tract, as well as drinking too much. If you're overweight, you'll almost certainly be advised to lose weight.
If your problem is severe, you might be referred to a continence adviser - a specialist nurse at an NHS continence service – or a urogynaecologist, who specialises in urinary problems in women. They can advise you about more intensive pelvic floor training exercises.
Your specialist will check the strength of your pelvic floor muscles, then prescribe a programme of exercises based on your assessment.
If you can't contract your pelvic floor muscles for any reason, electrical stimulation of the muscles might be the next strategy. This is done via a small probe that emits an electric current and is inserted into the vagina. It measures and stimulates the electrical signals in the muscles.
Another way of strengthening the pelvic floor muscles in by using vaginal cones. These are cone-shaped weights of differing sizes and weights that you have to hold in place using your pelvic floor muscles. You progress from the lightest weight to the higher ones as your muscles improve in strength.
Bladder training may be prescribed in combination with pelvic floor training. It involves learning techniques to hold on before having to wee. The course will usually last for at least six weeks.
You may be offered surgery if your stress incontinence doesn't respond to any of the above treatments. There is also medication available if surgery isn't the best option for you.
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