Stress urinary incontinence is involuntary urinary leakage with exertion and/or change in intra-abdominal pressure – activities such as coughing, sneezing, laughing, jumping, lifting, running. It’s common, normal, and treatable!
Why it happens:
Essentially, stress urinary incontinence occurs when pressure downward on the bladder exceeds the body’s ability to match it and keep urine in using active and passive support mechanisms.
Active support: Pelvic floor muscles and urethral sphincters
Passive support: Connective tissue suspending the bladder and urethra against gravity and pressure
Stress urinary incontinence and pregnancy
- Up to 69% experience stress incontinence by the third trimester of pregnancy
- About 33% of postpartum people experience it, with prevalence decreasing with time
Stress urinary incontinence and prostatectomy
- Up to 40% of people experience stress incontinence following radical prostatectomy
- Read this on post-prostatectomy physical therapy!
Treatment strategies for stress urinary incontinence
- Pelvic floor muscle training is the gold standard treatment for stress incontinence in both female and male anatomy. Read this to learn how to do a kegel (pelvic floor muscle training)!
- The “knack”: Performing a pelvic floor contraction prior to cough/sneeze/lift when leaking occurs
- Pessary (for female anatomy): a medical-grade silicone device that augments passive support to the bladder/urethra and reduces the effect of pressure changes.
- Fit by a urogynecologist or gynecologist, and may require several tries to find the right size
- Removable and can be worn anytime you find it beneficial (just for exercise, all day, etc). A pessary works immediately, but only when you’re wearing it
- Over-the-counter products such as Revive and Poise Impressa act similarly to a pessary and are easy options for many to try
- Surgery aims to increase passive support to the urethra against downward pressure
- Incontinence surgery is performed by a urologist or urogynecologist, and only after individual evaluation of your anatomy, risks, and benefits.