Stress Urinary Incontinence

Dr Shirin Lakhani

Adviser: Dr Shirin Lakhani

Stress Urinary Incontinence Image

Introduction

Stress urinary incontinence (SUI) is the involuntary leakage of urine during activities that increase pressure on the bladder, such as coughing, sneezing, laughing, or exercising. This condition is common during menopause and perimenopause due to hormonal changes, particularly the decline in oestrogen. Oestrogen helps maintain the strength and elasticity of the pelvic muscles and tissues that support the bladder and urethra. When oestrogen levels decrease, these tissues can weaken, making it harder to control urine leakage.

Additionally, aging, pregnancy, childbirth, and overall weakening of pelvic floor muscles can contribute to SUI, making it more common as women approach menopause.

Signs

What Are the Typical Signs?

The most common signs of stress urinary incontinence include:

  • Urine leakage when coughing, sneezing, laughing, or lifting heavy objects
  • Urine leakage during physical activities, such as running or jumping
  • Difficulty holding urine when there is sudden pressure on the bladder
  • Increased frequency of accidents or leakage throughout the day

These symptoms can vary in severity, ranging from minor leaks to more significant and frequent urine loss.

Tips

Tips on How to Manage or Reduce Symptoms

Lifestyle Tips:

  1. Pelvic Floor Exercises (Kegels): Performing Kegel exercises regularly can help strengthen the pelvic floor muscles, which support the bladder and improve bladder control. Aim for three sets of 10-15 contractions per day.
  2. Bladder Training: Schedule bathroom visits at regular intervals and gradually increase the time between trips to train your bladder to hold urine for longer periods.
  3. Maintain a Healthy Weight: Excess weight can put additional pressure on the bladder, worsening symptoms. Losing weight through a balanced diet and regular exercise can help alleviate incontinence.
  4. Avoid Bladder Irritants: Reduce or eliminate caffeine, alcohol, and spicy foods, which can irritate the bladder and worsen symptoms.
  5. Stay Hydrated: While it may seem counterintuitive, drinking enough water is important. Dehydration can concentrate urine, irritating the bladder.
  6. Quit Smoking: Smoking can cause chronic coughing, which increases bladder pressure and exacerbates incontinence.

Practical Tips:

  • Use Absorbent Pads: Incontinence pads or liners can help manage leaks and prevent accidents from affecting daily activities.
  • Wear Comfortable, Easy-to-Remove Clothing: This can make it easier to get to the bathroom quickly when needed.
  • Practice Double Voiding: After you urinate, wait a few seconds and try to go again to ensure your bladder is fully emptied.

Conclusion

Treatment Options:

  • Physical Therapy: Specialized pelvic floor physical therapy can help strengthen muscles and improve bladder control.
  • Medications: Certain medications can help manage incontinence, although they are more commonly used for other types of urinary incontinence.
  • Medical Devices: Vaginal inserts or pessaries can provide additional support to the urethra and reduce leakage.
  • Surgical Procedures: In severe cases, surgery such as a bladder sling or urethral bulking may be recommended to provide long-term relief.

Conclusion

Stress urinary incontinence is a common issue for women during menopause and perimenopause, driven by hormonal changes and weakened pelvic muscles. While it can be distressing, there are many effective management strategies, from lifestyle modifications to medical treatments. Taking proactive steps, such as doing pelvic floor exercises and seeking professional help when necessary, can greatly improve symptoms and quality of life.

FAQ's

Yes, Kegel exercises can be very effective in strengthening the pelvic floor muscles and improving bladder control. Consistency is key, and it may take a few weeks to notice improvement.

HRT may help improve the strength of the pelvic tissues in some women, but it is not a guaranteed treatment for SUI. Discuss with your healthcare provider whether HRT is appropriate for you.

Surgery can be a long-term solution for severe cases, but many women find significant improvement with non-surgical treatments like pelvic floor therapy, lifestyle changes, or using medical devices. Surgery should be considered after exploring less invasive options.