Stress urinary incontinence (SUI) is loss of urine that occurs at the same time as physical exertion. Activities like sneezing, coughing, or exercise increase the pressure or “stress” on the bladder. This pushed urine out of the body.
SUI affects one in three women over 45 years old. Women most commonly develop SUI from changes that happen in pregnancy or child birth which weaken the support to the urethra. Chronic coughing, constipation, obesity, aging, smoking, or extreme weight lifting can also cause SUI. Genetics may also play a role.
The bladder walls are make of muscles. As urine flows into the bladder, the walls expand to make room for more fluid, like a water balloon. Sudden pressure caused by activity through the urethra, the tube that carries urine of the body.
Some women leak occasionally, for example, only with intense exercise, heavy coughing, or when their bladder is very full. Others leak with activities such as walking or laughing. Women may limit physical and social activities to avoid SUI. There is no provider about treatments that can make you dry.
There are different kinds of urine leakage. To diagnose your problem, you will be asked questions about when and how often you leak urine. A physical exam will help identify other conditions that influence the bladder, such as pelvic organ prolapse. As part of the exam, you will be asked to cough or strain with full bladder to see if you leak.
Additional tests might include:
- Urine analysis to check for a urinary tract infection
and blood in you urine.
- Ultrasound to assess how much urine remains in
your bladder after urinating.
- Urodynamics to provide information on your bladder
You may be asked to complete a bladder diary. This requires you to record what, how much, and how often you drink. You also measure the amount you urinate. This will help your provider learn more about your bladder symptoms.
Your health care provider will first ask about your symptoms. Then, to confirm the diagnosis, a urine test is usually done. Your urine test is usually done. Your urine is tested for components like blood, bacterial byproducts and cells that indicate infection. This test can be done quickly in the office, and then a urine culture may be performed to determine the type of bacteria present as well as the best antibiotic to use.
The ideal SUI treatment depends on your symptoms and bother, You may want to first try conservative treatments such as lifestyle changes, pelvic floor muscle exercises, or a vaginal pessary. There are no medicines that help this problem.
There are lifestyle changes you can embrace to reduce symptoms: – Keep your bladder empty. Try to urinate every 2 to 3 hours. -Maintain your weight in a normal range and lose weight, if you are overweight. – Quit smoking. – Treat constipation and stop straining with bowel movements. – Stop extreme weight lifting activities and avoid repeated heavy lifting.
PELVIC FLOOR PHYSICAL THERAPY
Most women find that pelvic floor muscle exercises (Kegels) help improve symptoms. For the best effect, work with a specialized physical therapist to learn the techniques. Ask your provider for a referral. Then use these exercises every time you feel a cough or sneeze coming. It may take 3 to 6 months of regular pelvic floor muscle exercise to see results.
A pessary is a silicone device inserted into the vagina. It is similar to a diaphragm. Pessaries push the urethra closed to help control urine leakage. They still allow you to urinate normally when you need to. Some women wear a pessary only when they exercise. Others leave it in all the time.
URETHRAL BULKING AGENTS
In this procedure, a substance is injected near the urethra to “bulk up” the walls. This works well when a sphincter muscle that circles the urtehra weakens. There are different types of bulking agents. This outpatient procedure is usually done in the office. It is low risk and allows you to continue to be active immediately, but wears off after several month. The injections will need to be repeated.