The Inside Scoop on Incontinence #1: Stress Incontinence

June 4, 2024

Welcome to our Incontinence Inside Scoop series! For our first deep dive into all things incontinence, we are going to take a look at stress incontinence. 

What is Stress Incontinence?

Stress incontinence is a type of urinary incontinence characterized by the unintentional loss of urine during physical activities that increase abdominal pressure. This condition is most commonly seen in women, particularly following childbirth or menopause, but it can also affect men, especially after prostate surgery. The leakage occurs when activities such as coughing, sneezing, laughing, or exercising put pressure on the bladder, overcoming the urethral sphincter’s ability to retain urine.

Causes of Stress Incontinence

The underlying causes of stress incontinence often relate to weakened pelvic floor muscles or a compromised urethral sphincter. In women, childbirth can stretch and weaken the pelvic floor muscles and supportive tissues, leading to inadequate support for the bladder and urethra. Hormonal changes during menopause can further diminish the strength and function of these muscles. In men, prostate surgery, particularly procedures for prostate cancer or benign prostatic hyperplasia, can damage the sphincter muscles, leading to similar symptoms.

Diagnosis of stress incontinence typically involves a combination of patient history, physical examination, and possibly specialized tests such as urodynamic studies or cystoscopy. Treatment for stress incontinence encompasses a range of options tailored to the severity of the condition and the individual’s health status and lifestyle. Conservative approaches are often the first line of treatment, with pelvic floor muscle training, such as Kegel exercises, being highly recommended to strengthen the muscles that support the bladder and urethra. Biofeedback and electrical stimulation can enhance the effectiveness of these exercises. Lifestyle modifications, including weight loss, dietary changes to avoid bladder irritants, and quitting smoking, can also alleviate symptoms. For women, vaginal pessaries or urethral inserts may be used to provide additional support to the bladder neck and urethra.

Tackling Stress Incontinence

When conservative measures are insufficient, medical treatments may be considered. Pharmacological options include topical estrogen therapy for postmenopausal women, which can improve the tone and function of the urethral and vaginal tissues. In more severe cases, surgical interventions may be necessary. The most common surgical treatment is the insertion of a midurethral sling, which provides support to the urethra and helps to prevent urine leakage during physical activity. Other surgical options include colposuspension, which lifts and secures the bladder neck and urethra, and the injection of bulking agents around the urethra to improve its closure mechanism. Each treatment plan is customized to the patient’s specific needs, ensuring a comprehensive approach to managing and mitigating the symptoms of stress incontinence.

 Incontinence Solutions at Austin Urology Institute

Our team of experts led by one of Austin’s best urologists, Dr. Shaw, provide our patients with a suite of incontinence solutions to meet their medical needs.

If you are struggling with incontinence, you don’t have to! Give us a call today to schedule an appointment.