INCONTINENCE, STRESS

 Basic information

description

Stress incontinence is the involuntary leaking of urine that occurs with sudden increased pressure on the bladder. It can affect both sexes (males rarely) and all ages. It is most common in older women.

FREQUENT SIGNS & SYMPTOMS

Leaking of urine. This may happen with lifting, sneezing, singing, coughing, laughing, exercising, sports activity, crying, or straining to have a bowel movement. It may also occur with small movements such as rolling over in bed or standing up from a sitting position.

causes

It is usually due to pelvic floor muscle or sphincter muscle problems. Pelvic floor muscles support the bladder. Sphincter muscles keep the opening of the bladder closed until it is time to urinate, and then they relax. When these muscles become weak or don't function properly, urine can leak out from the bladder.

risk increases with

• Older adults; females; pregnancy and childbirth.
• Obesity.
• Surgery or radiation of the genitals or urinary tract.
• Chronic cough (may be due to smoking) or asthma.
• Prostate problems in men.

PREVENTIVE MEASURES

• There are no specific preventive measures. To reduce your risks: maintain a healthy weight, exercise daily, don't smoke, and limit alcohol and caffeine intake. Get physical exams to detect early problems.
• Strengthen pelvic floor muscles with Kegel exercises
  • First step is to identify pelvic floor muscles. When urinating, stop the flow by squeezing the pelvic floor muscles. Another way is to insert a finger into vagina (women) or rectum (men), then tighten the muscles around the finger. Repeat each method until you are sure you can feel which muscles are involved.
  • The exercises can be done any time and any place, lying down or sitting up. Start by emptying the bladder.
  • Tighten the pelvic floor muscles and hold for a count of 10.
  • Relax the muscles completely for a count of 10.
  • Perform 10 exercises, 3 times a day (morning, afternoon, and night). Don't do more than this.
  • It may take 6 weeks to 3 months for improvement.

expected outcomes

Kegel exercises can be effective for mild stress incontinence. With more severe incontinence, other treatment steps may cure the problem or help reduce symptoms.

possible complications

Physical problems are rare. It can affect quality of life.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask questions about your incontinence symptoms. Medical tests of blood and urine may be done to check for other conditions. Additional tests may be done to help diagnose specific urinary-tract problems. You may be asked to keep a diary about your urination patterns.
• Treatment may involve weight loss, smoking cessation, cough suppression, Kegel exercises, drugs, pessary, other types of therapy, or surgery.
• Other therapies include biofeedback, electrical stimulation, bladder training, or special weights to strengthen pelvic muscles. These options will be explained to you.
• Learn and practice Kegel exercises. Try to use the squeezing technique just before any sneeze or a cough.
• Wear absorbent underpants or incontinence pads.
• A pessary (support device) to fit inside the vagina to support the uterus is helpful for some women. Other types of devices include urethral plugging or stenting.
• If other methods fail, surgery to tighten relaxed or damaged muscles that support the bladder helps some. Even with surgery, some leakage may continue.
• To learn more: National Association for Continence; (800) 252-3337; website: www.nafc.org or Simon Foundation for Continence; (800) 237-4666; website: www.simonfoundation.org.

medications

• Drugs to help sphincter muscles may be prescribed.
• Estrogen therapy may be prescribed for women.

activity

No limits. Get regular exercise.

diet

• Start a weight loss program if you are overweight.
• Limit intake of caffeine and alcohol.

 notify our office if

• You or a family member has symptoms of stress incontinence.
• Symptoms don't improve with treatment.

Special Notes: