Stress Incontinence

Overview

Stress incontinence occurs when physical movements or activities like coughing, laughing, sneezing, running, or lifting heavy objects put pressure on your bladder, causing urine leakage. It’s important to clarify that this type of incontinence is unrelated to psychological stress. Unlike urgency incontinence and Overactive Bladder (OAB), which are characterized by bladder muscle spasms and a sudden urge to urinate. Stress incontinence is more commonly affects women than men.

The condition can be embarrassing, often leading individuals to limit social and work activities to avoid potential discomfort around others. It may also deter you from engaging in physical or enjoyable activities. However, there are effective treatment options available that can help manage stress incontinence, allowing you to improve your quality of life.

Symptoms

If you experience stress incontinence, you may notice urine leakage when you:

• Laugh
• Cough or sneeze
• Exercise
• Bend over
• Lifting heavy objects
• Have sexual intercourse

You may not necessarily leak urine every time you engage in these activities, but any action that puts pressure on your bladder can increase the likelihood of leaking. Additionally, having a full bladder raises the chances of leakage.

If your symptoms bother you or interfere with your daily activities such as work, hobbies, and social life, it’s important to discuss them with your healthcare professional.

Causes

Stress incontinence occurs when certain muscles and tissues involved in urination weaken. These include the pelvic floor muscles that support the urethra, and the urinary sphincter muscles that control the release of urine.

Normally, as the bladder fills with urine, the valve-like muscles in the urethra stay closed to prevent leakage until you reach a bathroom. However, when these muscles weaken, activities that exert force on the abdominal and pelvic muscles can put pressure on the bladder. For example, sneezing, bending over, lifting, or laughing vigorously can result in urine leakage.

Female stress incontinence

In individuals assigned female at birth, the weakening of pelvic floor muscles and urinary sphincter may be due to:

• Giving birth. The sphincter or pelvic floor muscles may become weaker as a result of tissue or nerve injury sustained during childbirth. This injury can cause stress incontinence, which might appear years after delivery or shortly after.

Male stress incontinence

In individuals assigned male at birth, the weakening of pelvic floor muscles and urinary sphincter may be caused by:

• Prostate surgery. Prostatectomy, the surgical removal of the prostate gland, is a common treatment for prostate cancer. The most frequent cause of stress incontinence is this procedure. The sphincter, which is located just below the prostate gland and surrounds the urethra, may become weaker as a result of this surgery.

Other factors

Male and female stress incontinence can also be exacerbated by the following factors:

• Being overweight.
• Conditions that result in persistent coughing.

Risk factors

The following factors raise the chance of developing stress incontinence:

• Age. Age-related physical changes, such as weakening muscles, may increase your risk of developing stress incontinence. However, stress urinary incontinence can strike at any age.
• Obesity. Obese or overweight people are more likely to develop stress incontinence. The abdominal and pelvic organs are under more pressure when one is overweight.
• Nerve damage. Damage to the lower back or pelvic nerves.
• Prostate cancer or benign prostatic hyperplasia (enlarged prostate) surgery in men.
• Having diabetes.

Among the other risk factors for females are:

• Type of childbirth delivery. Urinary incontinence is more prevalent among individuals who have had vaginal deliveries compared to those who have undergone cesarean sections. Furthermore, the risk increases with the number of childbirths.
• Having a hysterectomy surgery.
• Menopause.