Stress urinary incontinence (SUI) is quite a frequent medical condition. It is basically the inability to retain urine in your urinary bladder or an involuntary loss of urine when physical forces are increased on the bladder due to physical movement. These include activities like coughing, sneezing, laughing, exercising and even lifting heavy weights. Stress Urinary Incontinence differs from urinary incontinence in that from it is not due to an overactive bladder, another common condition.
What are the causes of stress urinary incontinence (SUI) ?
- Stress Incontinence is seen more commonly among older women but is not only due to aging.
- Being overweight or obese also increases risk of Stress Incontinence.
- Smoking and chronic cough place a recurrent strain on the muscles of pelvic floor that then cause bladder leakage.
- Pregnancy and childbirth, especially multiple normal childbirths also may weaken and damage the pelvic floor, leading to loss support and ensuing bladder leakage.
- Nerve injuries to the lower back and pelvic surgery in that area also could lead to stress urinary incontinence.
What are the symptoms of stress urinary incontinence ?
Women can experience a varied spectrum in the amount of urinary leakage that can occur at times of stress. This can range from loss of only few drops to bigger tablespoons or sometimes even more. Stress Incontinence is divided into degrees, based on severity of urinary leakage. Incontinence is generally mild in women who only have light leakage in rigorous activity like playing sports or exercising, or from sneezing, coughing, laughing or lifting. On the other hand, larger volumes of urine loss or urinary incontinence that occur with even low impact movements like standing up, walking, or bending over may be classified as moderate to severe degree of Urinary Incontinence.
How is stress urinary incontinence diagnosed ?
- Bladder Diary : Keeping a bladder diary is recommended. This will be a record of your exact fluid intake, number of trips to the bathroom and urine leakage episodes. It helps gauge your bladder control problems. This record helps you to maintain a practice called timed voiding, so incontinence is avoided as far as possible. As you slowly gain control, you can start to extend the time between bathroom trips.
- Urodynamic Studies : These investigate the bladder’s ability to both fill-up and empty, and the cause or the mechanism behind this incontinence.
- Ultrasound Scan : This can determine how much residual urine is present in the bladder after it empties. It also checks for any other causes for your symptoms.
- Urine Tests : These are done to rule out urinary tract infections.
What is the treatment of stress urinary incontinence ?
This treatment is wide and varied, from exercise to surgery, based on the symptoms. To seek professional help is the first step in treatment of stress incontinence.
- General lifestyle changes : Drinking only adequate amount of water enough to pass urine 4 to 6 times per day (usually about half a gallon) helps to prevent excessive urine passage. Maintaining a healthy weight and avoiding obesity has been shown to reduce stress incontinence; avoiding constipation and cutting down on smoking also has been shown to help.
- Pelvic floor exercises & bladder training : Pelvic floor exercises can be a very effective way of improving stress incontinence symptoms. A majority of women show an improvement in leakage after these exercises. Like all training programmes, the benefits of pelvic floor exercises are seen maximally if practice is carried out regularly and over a period of time. The maximum benefit is seen after 3 to 6 months of regular exercise. It is better to see a therapist who specializes in pelvic floor exercises in order to supervise this program. Bladder training involves Kegel exercises to strengthen the muscles holding in urine. Kegel exercises strengthen bladder muscles and keep it closed. The right muscles are those you can contract by imagining you are trying to stop passing gas. Squeeze the muscles you would then use. If you feel a “pulling” sensation, those are the precise muscles for pelvic exercises.
- Continence devices : Continence devices fit into the vagina and help control urinary leakage. These include aginal pessaries which can be either inserted just prior to exercise or otherwise worn continually. Using a large tampon before exercise may definitely reduce leakage.
- Surgery for stress urinary incontinence : Another method for treatment is surgery for stress urinary continence. The aim of surgery is to correct weakness of the supporting structures of the neck of bladder. Future pregnancies can compromise the results of the surgery, so many surgeons avoid surgery until a woman’s family is complete so as to not have unnecessary surgery. Surgeons have come up with different techniques for re-positioning and supporting the bladder in its normal position. The chief surgeries are retropubic suspension and sling procedures.The first type, the retropubic suspension uses surgical threads called sutures to support the neck of the bladder. The most commonly done retropubic suspension procedure is known as the Burch procedure. In this surgery, the surgeon places an incision in the abdomen, a little below the navel and then ties the threads to the strong ligaments of the pelvis to support the sphincter. This is commonly done at the time of an abdominal procedure like hysterectomy. The sling procedures are done through a vaginal incision. The traditional sling procedure uses your own tissue fascia to support the bladder neck. The other slings can consist of natural tissue or man-made materials. The surgeon has to attach both of the sling ends to the pubic bone or has to tie them in the front part of the abdomen just above the pubic bone.
- Bulking Agents : Substances called bulking agents may be injected in and around the bladder neck as well as into the urethral sphincter to increase their bulk and reduce the lumen size of the urethra. Many different substances can be injected into urethra including fat and collagen. The injection can be performed either in the office or outpatient surgery. Many of the surgeries are performed under local anesthetic only.
How to find urologists for stress urinary incontinence (SUI) surgery ?
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Find and choose an urologist for stress urinary incontinence (SUI) surgery on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
