Home :: Stress Incontinence

Stress Incontinence

Stress incontinence involves an involuntary loss of urine that occurs with increased intra-abdominal pressure. Activities that increase abdominal pressure include laughing, coughing, sneezing, or heavy lifting.
Stress incontinence is the most common type of urinary incontinence in women.

Causes

Shortening of the urethra and loss of the normal muscular support for the bladder and floor of the pelvis. These changes occur during pregnancy and after childbirth, particularly repeated childbirth. They may also occur as a natural consequence of aging. They are made worse by obesity.

Signs and symptoms

Unintentional loss of urine with exercise, lifting, sneezing, singing, Coughing, laughing, crying or straining to have a bowel movement.

Diagnosis

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Urinalysis to determine if a urinary-tract infection is causing the symptoms.

Treatment

The choice of a specific treatment will depend on the severity of the symptoms and the extent that the symptoms interfere with your lifestyle. There are four major categories of treatment for stress incontinence: behavioral changes, pelvic floor muscle training, medication, and surgery.

Medication

Medicine usually is not necessary for this disorder, but your doctor may prescribe:

• Antibiotics if you have a complicating urinary-tract infection.
• A pessary (support device) made of plastic, rubber or other material to fit inside the vagina to support the uterus and lower muscular layer of the bladder.

Home Treatment- Learn to recognize, control and develop the muscles of the pelvic floor. These are the ones you use to interrupt urination in midstream. The following exercises (Kegel exercises) strengthen these muscles so you can control or relax them completely:

• To identify which muscles are involved, alternately start and stop urination when using he toilet. Another method is to place finger just inside the opening of your vagina and squeeze the finger with your vaginal muscles.
• Practice tightening and releasing these muscles while sitting, standing, walking, driving, watching TV or listening to music.
• Tighten the muscles a small amount at a time like an elevator going up to the 10th floor." Then release very slowly, "one floor at a time. "
• Tighten the muscles from front to back, including the anus, as in the previous exercise.
• Practice exercises every morning, afternoon and evening. Start with 5 times each, and gradually work up to 20 or 30 each time.

Prevention

• Empty your bladder before exercise.
• Eat a normal, well-balanced diet and exercise regularly to build and maintain muscle strength.
• Learn and practice Kegel exercises (see Home Treatment) after childbirth, before symptoms of stress incontinence begin. If you have passed menopause, practice Kegel exercises even if you have not given birth.