Although stress incontinence affects both men and women, females are nearly twice as likely to have the condition. It occurs when the pelvic floor muscles weaken, leading to urine leakage when pressure is applied to the bladder area. Stress incontinence often coexists with pelvic organ prolapse.
For women, childbirth is one of the greatest risk factors for the condition. While giving birth, connective tissue can stretch or tear and nerves may become damaged leading to symptoms either immediately after childbirth or later in life. Other risk factors include older age, being overweight or obese, increased parity, prolonged labor, giving birth to a bigger baby, mode of delivery, smoking and repetitive heavy lifting.
Even though it’s not usually a physically painful condition, stress incontinence can lead to distress and discomfort at work and in social situations. Fortunately, there are ways to successfully manage the condition so you can get back to your daily activities without worrying about embarrassing leakage.
The main symptom of stress incontinence is urine leakage during certain activities, including:
- Exercising – especially activities that put pressure on your bladder area such as running or lifting weights
- Lifting heavy objects
- Having sex
Fortunately, there are several options to manage and treat the condition. We typically start with more conservative treatments, such as pelvic floor exercises and losing weight, if necessary. Pelvic floor exercises and weight loss can improve symptoms by nearly 50 percent. If a patient is unable to contract her pelvic floor, I recommend physical therapy. Some patients may also use a vaginal pessary or tampon inserts to help prevent urine leakage. Often these treatments are all it takes to successfully manage symptoms.
Patients who need further intervention may consider surgery. The most common is a sling procedure, during which a surgeon takes a vaginal or abdominal approach to place a small piece of either a biological or synthetic material to support the urethra. Because the surgery is minimally invasive, patients are able to recover faster and get back to their regular activities sooner. Surgical treatment has consistently shown greater long-term benefit over pelvic floor exercises, however, it is best avoided in women who plan future childbearing.
Many people are too embarrassed to ask for help when they experience symptoms but it’s important to speak up and discuss your situation with your physician. In most cases, there are treatments that can significantly reduce or eliminate distressing urine leakage and greatly improve your quality of life.