Stress Incontinence: Its Symptoms and Causes
Stress Incontinence: Its Symptoms and Causes
If you are eager to understand more about the condition known as “stress incontinence,” you must first understand the more general meaning of incontinence. Generally, incontinence is defined as an “inability of the body to control the evacuative functions of urination or defecation : partial or complete loss of bladder or bowel control”.
As one might then imagine, incontinence can be caused by a long list of issues. For example, medical experts point to the following:
- UTI or urinary tract infection
- Prostate issues
- Multiple sclerosis
- Parkinson's disease
- Bladder problems, such as infections and bladder stones
- Certain medications, among other issues
They also break incontinence into five different “types” that include:
- Urge – Often called overactive bladder or OAB, it is manifested as an urge to urinate whether the bladder is full or empty
- Mixed – A combination of urge and stress incontinence types
- Overflow – An inability to fully empty the bladder causes urinary leaks when the bladder is full
- Functional – This is often due to a medical condition that prevents an adequate amount of time to reach the bathroom (e., those with arthritis may be unable to move quickly enough to reach the bathroom)
- Stress – This is when you leak urine whenever you cough, lift something, workout or exercise, sneeze, or even laugh. Essentially, anything that causes pressure to the bladder will allow it to leak.
It is that last type, stress incontinence that we will focus on for the remainder of this article.
Stress incontinence is the involuntary leaking of urine when you are doing physical activity or caused by something putting pressure on the bladder, this means it is not nerve related or due to psychological stress (which many automatically think of when they hear the term “stress”).
It can occur in both genders, but is more common among women, usually because of issues relating to overuse or challenges in the pelvic floor area. For example, a woman who has given birth (whether cesarean or naturally) may struggle with bladder control issues and find that she experiences stress incontinence whenever she sneezes or lifts heavy items.
Generally speaking, stress incontinence is due to weakening of the muscles and/or tissues that support the bladder, also called pelvic floor muscles, weaken. Our bladders grow as they fill with urine, and the urethra remains tightly closed to hold the urine in until we consciously release it. Muscle weakening though, allows any pressure on the bladder to let urine out.
And while we looked at many causes for incontinence, many people must also consider that certain risk factors apply and may contribute to the development of stress incontinence. Age, body weight, the type of childbirth a woman experiences, and any surgical procedures on the pelvis can play a role.
What to Do About Stress Incontinence
Whether male or female, it is an embarrassing and unpredictable issue, and so yet it is quite treatable. Let’s first look at the basic symptoms that might help you determine if the urinary incontinence you are experiencing is, in fact, stress incontinence.
Typically, a person living with or developing stress incontinence will leak urine whenever they:
- Stand up quickly
- Lift heavy items
- Exercise or run
- Cough hard
- Laugh hard
- Engage in sexual intercourse
Often, stress incontinence occurs with one or more of these activities, but may be limited to something unlisted, something as simple as a pet climbing on your lap may cause you to contract the muscles of the abdomen and leak urine due to the pressure increase on the bladder.
Of course, the fullness of the bladder may also have an impact on the condition, and you may not leak urine until your bladder has reached a fuller level.
There will, naturally, come a time when you recognize that something must be done about it. While there are simple pads and shields and a myriad of other incontinence products to protect you from embarrassing situations, you must first visit a doctor and rule out any medical issues. After all, as we saw earlier, stress incontinence is often paired with urge incontinence, and this can be medically related.
Visiting a doctor will allow the physician to look at your medical history, provide a physical exam that considers any issues with the abdominal area and the genitals, and ensure a urine sample is tested for such things as blood, infection and so on. Your doctor may also have you do a urinary stress test that checks to see if you do leak urine when you consciously bear down on the pelvic muscles.
When a medical issue is suspected, your doctor may order any number of bladder function tests that include measuring residual urine via catheter once your bladder is entirely empty. They may also do an ultrasound of the bladder. They may ask for a cystometry test that examines the pressure in the bladder, a cystoscopy to consider if there are cysts in the bladder, or even urodynamics testing to watch how the bladder behaves at all times.
Treatments Available for Stress Incontinence
There is no single treatment for stress incontinence simply because there is no single cause. For most people, it ends up being a number of steps to help overcome or live with the condition. These include:
- Behavioral therapies – These may involve daily pelvic floor training, such as kegel muscle exercises or the use of biofeedback. Scheduled fluid consumption to avoid bladder over-fullness, lifestyle changes like smoking cessation or dieting, and bladder training programs
- Medical intervention – There are some medical devices, such as urethral inserts and vaginal pessaries that can be used, and surgical options can include the use of bulking agents in the area around the urethra, procedures to reinforce certain tissues, artificial sphincter implants, or mesh slings to support the urethra
- At home options – Many find that weight loss, changes to the diet (particularly if living with constipation), skipping beverages that might irritate the bladder and smoking cessation all work well. Kegel exercises or pelvic floor work can also be of benefit to most.
Almost any can experience stress incontinence, and if you feel you may be experiencing it, a visit to your physician is a wise choice. Talk with them about any possible health issues, and then use whatever remedies they recommend, as well as those outlined above.