Losing control of your bladder during normal movements and activities, such as during a sneeze or after standing, is known as stress incontinence. Despite the name, the condition is not caused by stress.
The name refers to a physical stress on the bladder, like bending over, which triggers an incontinence episode. It’s a condition that most commonly affects women, and most patients only pass a small amount of urine rather than emptying their bladder.
The leakage of urine at certain times is the only symptom of stress incontinence. Regardless of the cause, the resulting condition remains basically the same. Leakage may range from a single drop to multiple ounces of urine, and the triggers may change from time to time.
Stress incontinence occurs as a result of weakness in the pelvic floor muscles which help to control the opening and closing of the sphincter of the urethra. When muscles are weak, the sphincter is unable to close off completely, which leads to leaks of urine whenever the bladder is put under stress, such as when laughing, coughing, sneezing or during rigorous activity such as running.
There are many potential causes of pelvic floor weakness, but it very commonly occurs as a result of pregnancy and childbirth, when the pelvic floor muscles stretch and weaken as a result.
Some women experience stress incontinence immediately after having children, while others don’t develop it until they get older. As we age, and particularly when we go through menopause, muscles all over our body lose tone and become weaker, including the pelvic floor. Weakness already caused by having children can, therefore, worsen later in life and lead to stress incontinence.
There are other things that can contribute to pelvic floor weakness:
The treatment for stress leakage depends on the cause. For patients with weakened pelvic floor muscles, exercises with a weighted device build up muscle strength to naturally control the bladder’s function. When this doesn’t work, the muscles may need surgical tightening instead.
Hormonal changes are addressed if they play a role, which is common in both women and men. Lifestyle adjustments like losing weight and visiting the bathroom more often before it’s necessary can also make a big difference in how much leakage you experience. Finally, women can use a device known as a pessary to put pressure on the urethra and prevent unexpected leakage.
One of the most important ways to prevent stress incontinence is to maintain a healthy pelvic floor by doing daily Kegel exercises. You should get into the habit of doing this while pregnant to help maintain strong muscles throughout the pregnancy and minimize the damage done to the pelvic floor during childbirth. However, women who start daily Kegels after having a baby will still be able to tone up their pelvic floor and reduce their risk of stress incontinence.
Those who are overweight can reduce the pressure on their pelvic floor by losing weight. Smokers should also try to quit, as this will benefit the health of their pelvic floor and reduce the risk of chronic coughing, which puts added pressure on the pelvic floor.