Treatment of Stressful Urinary Incontinence (women)

About the disease

Stressful urinary incontinence in women is characterized by the involuntary release of urine during physical activities or when their bladder is put under pressure. This condition develops if the pelvic muscles weaken and are not able to support the bladder properly. This condition can also develop due to emotional distress or certain psychological factors.

Most notably, lifting heavy objects or bending over quickly can put pressure on the bladder and cause urine to escape involuntarily. In women with a predisposition to stressful urinary incontinence, even ordinary physical exertions such as coughing, sneezing or laughing can cause leakage.

Women may experience a weakening in their pelvic muscles as a result of pregnancy and childbirth, a sedentary lifestyle or simply because of their age. Injury to the pelvic floor can also weaken the pelvic muscles. According to Healthline, 50% of all women over 40 years of age have some form of stressful urinary incontinence. Women of all ages who suffer from obesity or who consume large amounts of nicotine and alcohol are also more at risk of developing stressful urinary incontinence.

Symptoms

• Involuntary incontinence
• Weak pelvic muscles
• Inability to hold urine while laughing, coughing or sneezing

Diagnosis

• During a general examination, the doctor may ask the patient to cough, sneeze or laugh to determine whether there is any involuntary leakage of urine.
• The patient may also be asked to wear a special pad for a certain period of time, to determine whether there is any leakage of urine, which the pad will detect.
• The doctor will ask the patient to use the incontinence pad to compare the amount of leakage when performing physical exercise and when resting.
• A urinalysis can detect the presence of bacteria, blood or protein in the blood, which would indicate problems with the bladder.
• An X-ray and other imaging tests can rule out the possibility of infections or other conditions of the bladder, which could have caused stressful urinary incontinence.

Treatment

• Conservative treatment such as special exercises for the pelvic floor can help to strengthen the muscles that control the release of urine from the bladder. Notably, yoga and pilates are very effective in this.
• Retropubic colposuspension is a surgical procedure whereby the bladder neck is lifted. Sagging may have occurred due to childbirth or an accident.
• Vaginal band overlay is a surgical procedure whereby a special band is inserted. This supports the bladder and pelvic muscles and prevents urine leakage.

Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko