Stress Incontinence

General Information

Urinary incontinence is the inability to control urination. It has many causes. The problem may originate with the bladder or with the urethra, which is the canal that leads the urine from the bladder to the outside of the body. Often incontinence is the result of other illnesses and is only temporary. Incontinence varies from occasional episodes to total loss of bladder control.

Stress incontinence is a problem in older women. In these women, small amounts of urine are lost when they sneeze, cough, or suddenly strain. This occurs because of increased pressure within the abdomen and the inability of the muscles to support the bladder. The weakened muscles are a normal part of the aging process, but normally they do not weaken to the point of causing stress incontinence.

If your condition is mild, physical therapy can help by strengthening the muscles that support the bladder. You may not see results right away, but in a few months you should see results if you continue to exercise regularly. Sometimes your physician may prescribe some type of support device inserted vaginally, like a tampon or a pessary. In more severe cases, surgery may restore the weakened area so that the bladder can resist sudden straining, sneezing, or coughing without the unintentional release of urine.

Important Points in Treatment
If you have stress incontinence, your physician will carefully evaluate you to be sure that you have no infection of the urinary tract. You should have with you a list of all the medications you are currently taking. Include your over-the-counter (nonprescription) drugs as well as your prescription drugs. Drugs do not cause stress incontinence, but some cause the condition to get worse.

Exercises are often helpful. Particularly helpful are Kegel’s exercises. The goal of these exercises is to make you aware of and be in control of the muscles that are involved in urination. The best way to become aware of these muscles is to stop your urinary stream and then restart it voluntarily. Become familiar with the process of tightening, stopping urination, and relaxing then starting urination, with these muscles. Once you are familiar with these muscles, try tightening and relaxing them at other times (when not urinating). Do these exercises three times daily, starting with five sets (repetitions) of tightening and then relaxing the muscles at each session, or a total of 15 sets per day. Then progress slowly up to 25 sets (repetitions) at each session, or a total of 75 sets per day.

Overweight patients will notice a decrease in the frequency of involuntary urination when they lose weight.

Notify Our Office If ...

• You have any evidence of a urinary tract infection. Any of the following symptoms may indicate that you have such an infection: burning sensation while urinating, frequent urination of small amounts, cloudy urine, bloody urine, fever, chills.
• You experience a return of symptoms of stress incontinence. This is particularly important if symptoms return after you have had successful surgery to repair the bladder support area or after you have successfully completed your exercise therapy and have built up the muscles in that area. The return of symptoms could mean that you have an infection that needs treatment.