Stress urinary incontinence
Stress urinary incontinence (SUI) is defined as a sudden unintentional loss of urine during normal day to day activities. It is also commonly referred to as bladder weakness and weak bladder. If you have this problem you may notice leakage if you laugh, cough, sneeze, walk, exercise, or lift something.
It is extremely common and there are approximately 9 million people in the UK experiencing some form of stress incontinence. It can affect women and men of all ages, although it is more common among women. It is estimated that approximately one-third of women in the UK suffer from stress urinary incontinence. Stress urinary incontinence is not related to psychological stress.
What Causes Bladder Weakness?
Bladder weakness usually occurs when the muscles in the pelvic floor or sphincter have been damaged or weakened.
Both men and women have a pelvic floor. It is made up of layers of muscles which hold the bladder and bowel in place and help to stop leaks. The sphincter is a circular muscle that goes around the urethra (the tube that urine comes out of) and squeezes as the bladder fills up to create a seal so that urine can’t leak out.
In women, these muscles can be weakened during pregnancy by the extra weight and natural hormonal changes. Childbirth can cause more problems especially if delivery is prolonged or the baby is large. Forceps and ventouse assisted deliveries may increase the risk of damage, muscle tearing or episiotomies (where the muscle is cut to allow an easier birth) can cause further damage.
Some women develop stress urinary incontinence after the menopause. This is because the pelvic floor becomes weaker following hormone changes within the body. Even before the menopause, some women may notice that they have a weaker bladder than normal in the week before a period. Stress urinary incontinence may occur after a hysterectomy and also after operations on the bladder.
People who have been constipated for a long time or have a chronic cough may also be prone to stress urinary incontinence. Men can develop stress urinary incontinence if they are experiencing problems related to their prostate gland or post prostate surgery.
Treatment For Stress Urinary Incontinence
It is important to have your symptoms assessed by a health professional who will assess your bladder behaviour and pelvic floor and confirm that you have stress urinary incontinence.
The main treatment for stress incontinence is pelvic floor exercises. Surgery to tighten or support the bladder outlet can also help. Medication may be used in addition to exercises if you do not want, or are not suitable for surgery.
If you are concerned about your problem and it is starting to affect your day to day life make an appointment to see your doctor, continence nurse or specialist physiotherapist. A continence nurse and specialist physiotherapist are healthcare professionals who specialise in bladder and bowel problems.