Stress incontinence is the most common type of incontinence. In fact, it is estimated that as many as 1 in 5 women over the age of 40 in the UK have some degree of stress urinary incontinence.
How is Stress Incontinence defined?
Stress incontinence occurs when urine leaks due to sudden extra pressure within the abdomen and on the bladder. This pressure can be caused by a wide range of activities such as coughing, exercising or laughing. If the pressure is too much for the bladder outlet to withstand, urine leaks out as a consequence. Stress incontinence in women is often caused by pregnancy, childbirth and menopause, whereas it is common for men to develop stress incontinence following prostate surgery.
Here are some interesting facts that you may not already know about stress incontinence:
- Don’t confuse Stress Incontinence with Urge Incontinence: there is a difference between the two!
Although both are associated with involuntary and sudden leakages, there are important differences between the two. Urge incontinence is defined as having a strong urge to urinate before the loss of urine. Stress incontinence, on the other hand, is the loss of urine without an urge to void that is usually triggered by an activity causing an increase in intra-abdominal pressure. It is often associated with exercise, hitting a golf ball or a tennis ball, gymnastics, or high-impact aerobics. The underlying cause for stress incontinence is different from that of urge urinary incontinence. It is key to remember that stress incontinence is caused by increased pressure on a weak sphincter muscle and/or pelvic floor.
It is common for people to avoid exercising for the fear of leakages due to stress incontinence. If you are a frequent runner and suffer from leakages, you can read our blog on running with stress incontinence here.
- Women are more likely to develop stress incontinence than men
Research by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) has shown that women are twice as likely as men to suffer from stress incontinence. The most common causes of stress incontinence among women are pregnancy and childbirth, especially having multiple vaginal deliveries. During pregnancy and childbirth, the sphincter and pelvic muscles stretch out and are weakened. It is especially common for stress incontinence to develop due to the weight of the growing fetus on the bladder structures hormonal changes, which increase urinary output.
- Stress incontinence is more common in people who are obese
“Obesity, which often goes along with diabetes, definitely puts people at risk for stress incontinence”, claims Dr. Wolter, a bladder health expert. He asserts, “It will put more pressure on the bladder and the pelvic floor structures themselves.” The extra weight carried around a person’s middle puts undue stress and pressure on the muscles of the pelvic floor. This leads to the pelvic floor muscles getting weak and sagging. It has been proven that losing a modest amount of weight can improve urinary incontinence in overweight and obese women. According to research, even 5-10% weight loss can help symptoms drastically. Weight loss is therefore strongly advised in those with stress incontinence who are overweight or obese.
If you do have stress incontinence, therefore, it may be beneficial to keep an eye on your weight and ensure you are not making the problem worse. This does not have to be a dramatic amount of weight loss and can be done simply through cutting down on foods high in fat and sugar.
- Ageing can have an impact on the severity of stress incontinence
Although stress incontinence can affect people of all ages, stress incontinence is likely to develop or worsen as you get older. An elderly person may be uniquely susceptible to the development or worsening, of incontinence. This can often be due to hypoestrogenism, a decrease in urethral striated musculature, and the development of urodynamic detrusor over-activity.
Stress incontinence is also known to develop due to the adverse effects of common comorbid conditions, such as diabetes and congestive heart failure. However, stress incontinence should not be considered a normal part of ageing and is not something you should simply have to “put up with”.
- There are options available for treating stress incontinence
Although stress urinary incontinence is common, it should not be ignored. Fortunately, there are a large number of options available to prevent involuntary leakages. One of these options is to improve pelvic floor function and stop episodes of incontinence. The first step in doing this is to be evaluated by a physician who specialises in the pelvic floor. You can visit certain sports medicine physicians, gynaecologists or urogynecologists for help with this treatment.
Patients who visit the doctor regarding stress incontinence are often referred to women’s health physical therapists to learn exercises to improve their pelvic floor function. Different exercise regimes can suit different people, and a specialist can help you decide which method is suitable for you. For example, some women improve with Kegel’s, however, others may need to learn to relax their pelvic floor rather than strengthen it. In addition to therapy, there are medications, injections and surgical procedures that can be used if necessary. However, these procedures should only be used as a last resort, and it is recommended to try natural methods first.
A shocking 62% of women sufferers wait a year or longer before discussing stress incontinence with their doctor, reports a new Multi-sponsor Surveys’ Gallup Study of women with SUI. If you do have stress incontinence, you do not have to stay at home and avoid doing exercise. Ensure you talk to a doctor and find the most suitable treatment options for you.