Involuntary/unintentional leakage of urine is known as Incontinence. When this leakage occurs during physical activities such as laughing, coughing or sneezing without intention it is known as stress urinary incontinence.
Why does stress incontinence happen?
The abdominal pressure rises with activities such as coughing and sneezing that squeezes the bladder. This is similar to squeezing a plastic bag containing water. Normally the urine drains out through the natural opening of the urinary bladder which is guarded by a special muscle called sphincter. This sphincter along with the muscles of the pelvic floor prevents unintentional leakage of urine. However, if they are weak they cannot resist the force associated with actions of coughing and sneezing and leads to urine leakage.
What causes stress incontinence?
The weakening of the bladder and pelvic floor muscles causes stress incontinence. This weakening of the muscles is brought about by
- Age- Age related changes to the urinary system can lead to stress incontinence
- Multiple child births leads to weakening, stretching and dysfunction of the muscles of the pelvic floor.
- Excessive strain on the pelvic floor due to activities such as chronic cough, constipation.
- Urinary tract infection
What complications can occur due to SUI?
Due to constant leakage of urine, the local area is irritated and may cause redness and maceration of the local skin. This may lead to infections. It also causes a lot of personal distress and embarrassment. As such women avoid socializing and restrict themselves to their homes. They also avoid discussing the problem due to the embarrassment commonly associated with it.
How is stress urinary incontinence diagnosed?
Physical examination and understanding of patient history by a gynaecologist is the first step in diagnosis. An ultrasound scan of the bladder along with urodynamic studies is done that helps study the flow of urine. Additionally, to check for urinary infections a urine analysis and culture are routinely performed.
What is the treatment for stress urinary incontinence?
Identification of the factors that lead to stress incontinence is the primary step in the treatment process. If you are on medications that may increase your risk of incontinence, it needs to be changed. As discussed earlier, obesity is one of the risk factors for stress incontinence. For overweight people, weight reduction through diet control and exercise is necessary. Conditions that aggravate stress incontinence such as chronic cough or constipation if present must be corrected. To improve the strength of the muscles of the pelvic floor we teach you the Kegels exercises, a set of specialized exercises that when performed regularly, gradually improve the muscles that control the bladder.
In many cases, sling surgery is done to control string incontinence. This procedure uses synthetic mesh or a piece of your own tissue to create a support at the neck of the urinary bladder. This helps to keep the bladder closed such that urine does not leak out during sneezing or coughing. To minimize post operative pain and to aid speedy recovery, laparoscopic surgery is done.