Urinary Stress Incontinence
What is Urinary Stress Incontinence
Urinary stress incontinence (USI) in women is the involuntary loss of urine with any increased abdominal pressure, such as coughing or sneezing. 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?
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. Though usually considered a process of aging, USI occurs frequently in younger women in their 30’s and 40’s.
What Causes USI
USI can be caused by a variety of problems, but the most common causes are a “fallen” bladder, usually from repeated vaginal births, and a dysfunction of the muscles and ligaments of the outflow of the area of the bladder.
A “fallen” bladder results from the overstretching of the pelvic soft tissue that must give way for a baby passing through the birth canal during vaginal delivery. Though most of this tissue will recoil, the resultant tension and strength inevitably is less than before delivery. This is analogous to blowing up a balloon for a few days, then deflating it. Though no longer distended, the balloon remains somewhat flaccid and is no longer taught like before it was blown up. Interestingly, the dysfunction from birthing may not show up for years. Just as breasts and chins can sag with age, so does the support area of the bladder. But the result is functional, not cosmetic. Genetics plays a role as well. Some women will have no problems despite repeated deliveries, while others will have USI after just one delivery. Frequently there is a history of one’s mother, aunts or older sisters having similar problems, as precedents.
In some cases, bladder dysfunction occurs regardless of childbirth history. The sphincter and associated muscles may become weak for inherent reasons. The continence/voiding process in women is complex, and deficiencies are known to occur for many varied defects.
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
* Laughing
* Coughing
* Sexual intercourse
* Standing
* Sneezing
How Is Urinary Incontinence Treated?
There are several treatments for USI including:
* Behavioral changes like decreasing fluids, losing weight, avoiding alcohol or caffeine
* Pelvic muscle training (also called Kegel’s exercises)
* Bladder training techniques
* Estrogen therapy, if post-menopausal
*Surgical procedures to correct the anatomic defects
The most important breakthrough in the treatment of female urinary stress incontinence has been the evolution of the Bladder Sling. Surgical correction years ago involved a major operation with hospitalization and prolonged recovery. However, technology has now improved so that a minor 15 minute procedure under light anesthesia through a 1 inch incision inside the vagina can give equal results to correct USI for women. Pain is minimal and recovery is quick (check out the details in The Procedures page).
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