If you leak urine when you cough, sneeze, laugh, exercise or lift something, you may have stress urinary incontinence. This common type of urinary incontinence occurs when pressure on the bladder overwhelms the muscles and tissues that help prevent urine from leaking.
Stress urinary incontinence is common, particularly among women, but it is not something you simply have to live with. Treatment options range from pelvic floor therapy and lifestyle changes to minimally invasive procedures and surgery.
What Is Stress Urinary Incontinence?
Stress urinary incontinence is urine leakage caused by physical activity or pressure on the bladder. Despite its name, it is not related to emotional stress.
You may experience leakage when you:
- Cough or sneeze
- Laugh
- Exercise or run
- Jump
- Lift something heavy
- Stand up or change positions
When you cough, laugh or exercise, pressure inside your abdomen increases. Normally, the pelvic floor muscles and tissues surrounding the urethra provide enough support to keep urine from leaking. When those structures are weakened or no longer provide adequate support, leakage can occur.
What Causes Stress Urinary Incontinence?
Several factors can contribute to stress incontinence. Pregnancy and childbirth can affect the pelvic floor and tissues supporting the bladder and urethra. Hormonal changes associated with menopause may also play a role.
Other risk factors include:
- Aging
- Previous pelvic surgery
- Chronic coughing
- Constipation
- Being overweight
- Activities that repeatedly put pressure on the pelvic floor
Stress incontinence can also occur alongside other types of urinary problems, so an evaluation can help identify the cause of your symptoms.
How Is Stress Urinary Incontinence Diagnosed?
A urologist can determine whether your leakage is caused by stress incontinence or another urinary condition.
Your provider may ask when leakage occurs, how often it happens and whether you have other symptoms, such as urinary urgency or frequent urination. A physical examination may include an evaluation of your pelvic floor, and additional testing may be recommended depending on your symptoms.
This is important because stress incontinence differs from urge incontinence, which is often associated with overactive bladder. Some people experience both.
Can Stress Urinary Incontinence Be Treated Without Surgery?
Yes. Surgery is not always necessary.
Pelvic floor physical therapy can help strengthen and improve coordination of the muscles that support the bladder and urethra. Your provider may also recommend lifestyle changes such as maintaining a healthy weight, addressing constipation or modifying activities that trigger significant leakage.
If these approaches do not provide enough relief, additional treatments may be considered.
What Treatments Are Available?
Treatment depends on your symptoms, medical history and goals. Options may include pelvic floor therapy, minimally invasive procedures and surgery.
Bulkamid®
Bulkamid® is a minimally invasive treatment that uses injections around the urethra to help improve support and reduce urine leakage.
Sling Procedures
A sling procedure uses supportive material to help support the urethra and reduce leakage during activities that increase abdominal pressure.
Your urologist can discuss the benefits, risks and recovery associated with these and other treatment options to help determine what may be appropriate for you.
When Should I See a Urologist?
Consider talking with a urologist if bladder leakage is causing you to:
- Avoid exercise or physical activities
- Wear pads regularly
- Limit social activities or travel
- Worry about coughing, sneezing or laughing
- Change your daily routine
- Continue leaking despite pelvic floor exercises or other conservative treatments
You do not have to wait until leakage becomes severe. An evaluation can help you understand what is causing your symptoms and whether treatment could improve your quality of life.
Specialized Care at Urology Associates
Leaking urine when you cough, laugh, sneeze or exercise can be frustrating, but you do not have to simply live with it. Stress urinary incontinence is treatable, with several options available.
At Urology Associates, Dr. Ramy Goueli, is a board-certified, fellowship-trained urologist specializing in female pelvic medicine, reconstructive urology, neuro-urology and complex voiding dysfunction. He provides specialized care for women experiencing urinary incontinence, including treatment options such as Bulkamid®, sling procedures and other advanced treatments when appropriate.
If bladder leakage is affecting your activities or quality of life, Dr. Goueli and the team at Urology Associates can help you understand the cause of your symptoms and explore treatment options that may be right for you.
