Stress urinary incontinence (SUI) is the unintentional loss of urine during an activity that causes increased pressure. The most common activities that cause SUI are running, jumping, laughing and coughing. According to the U.S. Food and Drug Administration, it is the most common form of incontinence for women. Although SUI can affect women of all ages, symptoms are most common in women after vaginal delivery, surgery or during menopause.
SUI occurs when the urethra falls or descends due to weakening muscles. The weakened muscles are unable to keep the urethra from falling during activity of increased pressure, including exercise and coughing.
SUI can cause significant burden, distress and embarrassment for women. Many women avoid normal activities and exercise due to loss of urine. Conditions such as urinary tract infections, obesity, chronic cough, diabetes, and certain medications can make it worse. However, treatment of other chronic conditions can often decrease symptoms of SUI.
Nonsurgical treatment options may include a combination of behavioral modifications and supportive techniques and treatments such as:
Another treatment option is using a vaginal pessary, which is a small ring that is placed in the vagina to support the bladder and urethra. This is a removable device that helps support the bladder base to prevent urine leakage.
When nonsurgical treatments are unsuccessful, surgery may be considered. One surgical option is a tension-free vaginal tape or TVT, which is an outpatient procedure, performed by placing a sling under the urethra.
It is important to meet with your doctor to discuss all surgical and nonsurgical options. He or she will perform a pelvic exam, review your medical conditions, your medications, and may perform lab tests. You and your doctor should discuss the results of any tests and decide how they impact your treatment strategy.
Stress urinary incontinence doesn’t have to hinder your lifestyle. With the right treatment, you'll likely be able to manage incontinence and improve your overall well-being.
Emily Linklater, D.O., is a physician at Mayo Clinic Health System in Red Wing and specializes in women’s health. She is certified by the American Board of Obstetricians and Gynecologists.