Norton Hurley

Stress Incontinence: Causes, Symptoms, & Treatments

Stress incontinence is a type of urinary incontinence that occurs when added pressure, heavy lifting, or movement increases the force on the bladder, causing it to leak.

In this instance, “stress” refers to physical pressure, not emotional stress. Coughing or sneezing can also increase the pressure on the bladder, causing urine to leak out.

 

What causes stress incontinence?

Stress incontinence is caused by a weakening of the muscles and sphincters in and around the bladder.  The sphincters are ring-like structures at the bottom of the bladder and urethra that close to stop the flow of urine.

Some of these muscles are voluntary and can be controlled (as we learn during potty training an infant), while others deep inside are involuntary and cannot be consciously controlled. 

A bladder with the location of the sphincter denoted

Image: A bladder with internal and external sphincters.

When these structures and muscles weaken or do not receive the proper nerve impulses, they don't close all the way and allow urine to flow through them (similar to a leaky faucet).

What are the signs & symptoms of stress incontinence?

The main symptom of stress incontinence is a loss of bladder control when the body is placed under pressure or exerts itself. 

The amount of urine that leaks out can be as little as a few drops or as much as the full contents of the bladder.

This condition can be either acute (coming and going within a short amount of time) or chronic (lasting for a few months or longer). 

How is stress incontinence diagnosed?

If you are experiencing a leaking bladder, especially during times of exercise or physical activity, plan a visit with your doctor.  They will likely start with collecting your health history and performing a physical examination.

Some tests that may be ordered include:

  • Urinalysis- A test of the urine itself to detect any infections or abnormalities such as blood or sugar
  • Radiology- An x-ray or scan of the pelvic area to evaluate the structures of the urinary system to detect any masses or blockages
  • Urinary function testing- studies that can show the actual flow of urine through the bladder and urethra
  • Blood testing- To evaluate how the bodies major organs, including the kidneys are functioning

    Who is most affected by stress incontinence?

    Stress incontinence is most common in women over the age of 50.

    Approx 1 in 3 women experiences a form of incontinence at some point in their lives.

     

    Men and younger aged people can suffer from it as well, although it is not nearly as common.

    People who are most at risk of experiencing urinary incontinence are:

    • Women over the age of 50
    • Women who have delivered a baby or are pregnant
    • Someone with a spinal cord injury
    • Someone who is overweight
    • Smokers
    • Someone with a chronic cough
    • Men who have had prostate surgery
    • Someone who has had pelvic surgery
    • Someone is who is overweight

    What can trigger stress incontinence?

    Stress incontinence can happen anytime there is physical stress or pressure put on the abdominal/pelvic area.

    Activities that can trigger stress incontinence include: 

    • Coughing or sneezing
    • Bending over
    • Lifting heavy objects
    • Running or jogging
    • Jumping
    • Sexual intercourse

     Foods that trigger urinary incontinence include:

    • Alcohol
    • Caffeine
    • Nicotine/tobacco
    • Spicy or hot foods
    • Foods/drinks high in sugar
    • Acidic foods or beverages

     

    How do you cure stress incontinence?

    Living with Stress Incontinence can certainly pose some inconveniences, but is most often very treatable.  Aside from medications, there are a number of things that you can do to help you live a more normal and active lifestyle.

    Train Your Bladder

    a woman doing kegel exercises for stress incontinence


    • Kegel exercises - Contracting and releasing the muscles that you use to stop the flow of your urine.  Do this in sets of 10 several times per day, holding for 2-3 seconds on each contraction.

     

     

     

    • Timed voiding - Make yourself urinate once per hour (even if you do not feel the urge to go).  Then increase the time between voids by an hour each week, until you have reached the maximum of time you can wait without having any leakage (usually about 4 hours is the max).

    Keep a Bladder Diary 

    Create a log of your urinary habits.  Note when you have symptoms and what made them better or worse.  This helps you and your physician to learn what your limits are and what factors aggravate your symptoms.

      Lose Excess Weight 

      Being overweight adds extra pressure to the bladder, making stress incontinence worse.

      Maintain Healthy Bowel Habits 

      Constipation can increase the pressure in the abdomen and straining can weaken the muscles.  A diet high in fiber can keep constipation in check.  Adding a stool softener or mild laxative can help too.  If you are experiencing heavy constipation, see your doctor.

       

      Quit Smoking 

      Nicotine and tobacco themselves are bladder irritants.  On top of that, smokers tend to cough more.  This can really make stress incontinence leakage worse.

      Wear Absorbent Underwear

      Absorbent briefs or incontinence pads can help to protect your clothing from urinary leaks when they do happen.  When in bed or sitting on furniture, an absorbent underpad may be helpful to protect the furniture.

      Wear a Medical Device

      A pessary is a ring-like device, usually made out of plastic, that can be inserted into the vaginal canal to help to remove the pressure off of the bladder.

      A urethral plug can be inserted into the urethra (the tube that leads from the bladder to the outside of the body to excrete urine) to stop urine from being able to escape while it is in place.

      A penile clamp can put pressure on the male urethra, stopping urine from being able to pass through and can be released when it is time to urinate.

      Consider Surgery 

      A “sling” can be inserted surgically into the pelvis to hold the structures and organs in place, releasing the pressure that may be causing your stress incontinence.

      Injections of bulking agents (or even Botox) can put pressure where it is needed to help the urethra to close off the flow of urine when it is supposed to. An artificial sphincter can surgically replace a faulty one, mostly in males.

       

      Disclaimer: The information presented here is purely for educational purposes and should not be used in place of the advice of your doctor or physician.

       

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