Many people experience stress incontinence, but only a few seek medical care even though the condition can adversely affect their quality of life.
However, people living with stress incontinence should talk to their doctor, because there are treatment options available that can help.
What is stress incontinence?
Coughing can put pressure on the bladder.
When a person releases urine involuntarily as a result of physical action or activity that puts pressure on their bladder, they are experiencing stress incontinence.
Despite what its name may suggest, stress incontinence is related only to physical actions on the body and not emotional stress.
A person with stress incontinence may pee while coughing or doing any of the following activities:
- running or jumping
- having sex
- lifting something heavy
- standing up
During these activities, a person with stress incontinence will typically only leak a small amount of urine.
Stress incontinence causes a person to pee while coughing or sneezing. It should not be confused with urge incontinence, which occurs when urine leaks from a person's bladder due to feelings of urgency that make the bladder contracting.
Some people may have both stress incontinence and urge incontinence.
Causes of stress incontinence
Removal of the prostate gland, highlighted here, may cause stress intontinence.
Stress incontinence happens when pelvic muscles and tissues that support the bladder and control the urinary sphincter weaken. When this happens, the muscles will be unable to support the bladder and urinary sphincter properly, and urine will leak out.
The muscles that support the bladder are known as pelvic floor muscles. A variety of things can damage these muscles, and the causes are typically different for women and men.
The most common causes of damage to pelvic floor muscles in women are pregnancy and childbirth.
In men, the most likely cause of stress incontinence is the surgical removal of the prostate gland.
Risk factors for stress incontinence
Certain factors may make a person more likely to experience stress incontinence, such as peeing while coughing.
However, being a female is one of the most significant risk factors for stress incontinence. According to one study, 13 percent of women between the ages of 19 and 44, and 22 percent of women aged 45 to 64 will develop stress incontinence.
Women are more at risk for stress incontinence mainly due to pregnancy and childbirth. Women who have given birth are 8 percent more likely to develop stress incontinence than those who have not.
Also, women who give birth vaginally are more likely to develop stress incontinence than women who have a cesarean delivery.
Men can experience stress incontinence as well, particularly after prostate removal surgery.
Other risk factors that can make a person more likely to develop stress incontinence, regardless of gender, include:
- being more than 70 years old
- being obese
- having any prior pelvic surgery
- having certain medical conditions, such as overactive bladder
- experiencing chronic constipation
- having a pelvic organ prolapse
- having a history of low back pain
- having any condition that causes chronic sneezing or coughing
- having a history of doing high impact sports, such as running
Losing weight and maintaining good health may help with stress incontinence.
Stress incontinence is a relatively common occurrence, but there is no reason why a person should ignore the embarrassment or inconvenience the issue may cause.
There are treatment options available for stress incontinence, including lifestyle changes, use of devices, and surgical intervention.
In the first instance, most doctors will recommend that people with stress incontinence try a variety of lifestyle changes. These lifestyle changes can include any of the following:
- losing weight or keeping a healthy body weight
- quitting smoking
- timing consumption of fluids carefully
- limiting or avoiding caffeine
Most doctors recommend pelvic floor therapy or Kegel exercises as a way to strengthen weakened pelvic muscles. People can do these exercises independently, or with the help of a pelvic floor therapist who may use a technique called biofeedback.
To do a Kegel exercise, an individual should engage and hold the muscles that are used to stop the release of urine. They should repeat the exercise as often as possible.
Biofeedback involves stimulating the muscles electrically, during the exercises.
Behavioral modification therapy
One behavioral modification technique is bladder training. This technique involves sitting on the toilet to urinate at set intervals or at a particular time of day.
This procedure helps train the bladder to only release urine when sitting on the toilet. However, this technique is more effective for people with mixed incontinence than people who have stress incontinence only.
Sometimes, a doctor might recommend a combination of physical and behavioral modification therapy to help manage stress incontinence.
If lifestyle and behavioral modifications cannot control a woman's stress incontinence, she may require the use of a device to help manage it.
A vaginal pessary is a ring-shaped device with two bumps on it that sit on either side of the urethra. The pessary helps support the bladder so that urine does not leak when it is under stress.
Women may also choose to use a urethral insert during intense physical activity, such as playing sport.
In severe cases, a doctor may recommend surgery to help with stress incontinence. Surgery for stress incontinence aims to help the urinary muscle or sphincter close properly or provide additional support to the bladder.
A sling procedure is often used, where a sling is placed around the bladder to help support it. It is an effective type of surgery for women and men.
Simple lifestyle changes often go a long way towards preventing stress incontinence. Some steps a person can take to prevent stress incontinence include:
- replacing high impact with lower impact exercise
- strengthening the core muscles
- avoiding caffeine
- quitting smoking
- maintaining a healthy weight
- eating a fiber-rich diet
Any person who has stress incontinence should do Kegel exercises regularly to prevent involuntary urination when they cough or sneeze.
Even people who do not have stress incontinence should do these exercises to prevent the condition developing in the future. This is especially true for people who are at high risk for developing stress incontinence, such as pregnant women.
Stress incontinence is a widespread condition. Many people do not seek help for it due to embarrassment, but people with stress incontinence should not be afraid to talk to their doctor about options to help with its management.
Most people find they can manage stress incontinence with lifestyle changes and pelvic floor strengthening. In severe cases, a person may require surgery to help correct the problem.