Stress incontinence

Definition of stress incontinence - Stress incontinence is an involuntary ejection of urine usually precipitated by exercise, such as laughing, coughing or sneezing. It occurs when there is increased pressure from the abdomen, which presses down on the urethral sphincter. The sphincter muscle cannot cope with the excess pressure and it leaks urine. Stress always means a physical pressure on the sphincter it is never associated with stress in the sense of emotional stress.

What causes it
The most common cause is when the pelvic muscles which should support the bladder and urethra become weakened, it happens frequently during pregnancy, which is why women are more at risk. The secondary cause is a malfunction of the urethral sphincter the urethra may be weakened by medication, a neurological injury or trauma to the urethra and surrounding area.

Sphincter weakness may occur after surgery, it can occur in males following prostate surgery and in women following surgery in the pelvic region. The condition is more common in women especially after multiple pregnancies and vaginal deliveries because of the strain on the sphincter. It can also follow a pelvic prolapse where the bladder, the urethra or the rectal wall have collapsed into the vaginal area.

Medial studies have documented that fifty percent of all women irrespective of age have occasional urinary incontinence, whilst ten percent have frequent incontinence. Stress incontinence becomes more likely after the menopause and it affects one in five women over the age of seventy-five on a daily basis.

How much Urine escapes - Often it is just a little a dribble, but it can be a lot, sufficient for the outer garments not to hold the excess liquid causing excess urine to leak down the legs. Consequently, the psychosocial implications of incontinence may disrupt your life, both in the workplace, socially and at home. Physical complications other than the smell are not normal.

Risk Factors - Risk factors for stress incontinence include gender; it is more common in women, advancing age, childbirth, obesity and smoking. Smoking causes stress incontinence in both sexes as it may cause chronic coughing which aggravates stress incontinence. Any other clinical condition in which coughing occurs such as asthma and chronic bronchitis can also cause stress incontinence.

Prognosis - Pelvic floor exercise therapies are designed to strengthen the muscles so that they are capable of giving greater support. The pelvic floor muscles surround the urethra and exercise can improve their grip, and therefore lesson the chances of urine dribbling out of the bladder.

There is a constant trickle of urine down both ureters tubes which connects the kidney’s to the bladder, but the sphincter muscles should remain closed if they are functioning correctly.

Surgery can be extremely effective with a successful cure occurring in seventy five to ninety five percent of cases. Unfortunately, surgical candidates have to be carefully selected; it is often useless if the stress incontinence is accompanied by other urinary or genital problems. Sometimes other conditions affecting either the whole system or whole organs mean that the ability of tissue to heal is impaired or the technical aspects of the surgery become more difficult. In both of these cases, the surgical prognosis is not good. In certain cases, medication can be effective.

In conclusion the natural building up of muscles is less invasive and often more effective than surgery. Approximately sixty percent of all cases irrespective of age or gender respond well to muscle exercises. It takes several weeks of regular pelvic floor exercises to see any real improvement, few people notice an improvement in less than two months and it can take up to five months. However, the pelvic floor muscles are not visible and they can be exercised whilst you are sitting at the computer reading this article! You do not need any equipment to exercise. Obesity aggravates the strain and whilst pelvic exercises will help, the problem will improve with a sensible weight loss programme.

Once the problem has improved, you need to exercise the pelvic floor muscles for between five and ten minutes a day to keep them strong and prevent a relapse.

• • Terms and conditions
• • Contact us