Urinary Stress Incontinence
Urinary stress incontinence (USI) in women is the involuntary loss of urine. It could be a small or large amount, and episodes can range from occasional to frequent. Sometimes USI is so problematic that women avoid activities with others for fear of embarrassment.
How Prevalent Is USI?
USI is twice as common in women as in men. It’s more common in older women, but young women suffer from the condition as well. A 2002 survey by the Harris Interactive for the National Association for Continence found that almost one third of women in the USA over 18 years of age suffer from USI.
What Causes USI?
USI is usually caused by inability to control muscles in the bladder and sphincter where urine is stored and released. Incontinence occurs when the bladder suddenly contracts, forcing urine from the body, but the sphincter muscles cannot hold the urine back.
It can be a by-product of ageing, birth defects, menopause, stroke, or conditions like multiple sclerosis. It can also be caused by injuries to the kidneys, sphincter or urethra. Certain medications can cause USI, as can prostrate or pelvic surgery. Obesity can worsen this condition because it creates increased pressure in the abdomen
USI often affects women who have had more than one pregnancy. Weakened pelvic muscles are unable to support the urethra, a tube that allows urine to pass from the kidneys out of the body.
What Are The Symptoms of Stress Incontinence?
Urinary stress incontinence occurs when women perform activities that cause pressure on the bladder, resulting in a leakage of urine. These activities can include:
* Running and other forms of physical exercise
* Sexual intercourse
How Is Urinary Incontinence Treated?
The most modern and successful surgical treatment for USI is the vaginal sling. In this procedure, a sling is attached to the abdominal wall and placed around the urethra to support it and thereby increase urine retention. The sling may be made of natural or synthetic materials.
There are five other treatments for USI:
* Behavioral changes like decreasing fluids, losing weight, and avoiding alcohol or caffeine
* Pelvic muscle training (also called Kegel exercises) to strengthen the urethral sphincter
* Medications such as Alpha-adrenergic agonists and anticholinergic agents
* Oestrogen therapy
* Surgery like collagen injections, anterior vaginal repair, and retropubic suspension procedures