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Stress urinary incontinence

We've All Heard of Incontinence, But What is Stress Urinary Incontinence?

Stress urinary incontinence is the involuntary and embarassing leakage of urine. This can occur due to sudden pressure on the pelvic floor muscles such as coughing, sneezing, laughing or during exercise and physical exertion such as lifting a heavy object. Quite often there is no sensation of a need to urinate before the loss of urine.

SUI is a ‘warning shot’; your body's way of telling you that you need to strengthen your muscles and this must not be ignored.

Don’t pad the problem and don’t pretend it didn’t happen as you consign your wet knickers to the laundry basket, because damp urine soaked panties are smelly, uncomfortable and bad for your self-esteem!

The early signs of SUI should not be ignored because left untreated it can eventually lead to Pelvic Organ Prolapse.

Stress Urinary Incontinence Treatment

NICE (National Institute for Clinical Excellence) recommends the first-line treatment for Urinary Stess Incontinence or Stress Urinary Incontinence (SUI) is a course of pelvic floor exercises. When the pelvic floor muslces are strong it supports the bladder to prevent 'laughter leaks' and the associated embarassing accidents.

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What can you do about stress incontinence?

  • Kegel Exercises – Kegels or pelvic floor exercises will help strengthen the muscles in your pelvic floor so they can continue to support your vital organs giving you greater control.
  • Vaginal Pessary – A pessary device inserted into the vagina presses against the bladder neck and urethra so you have less leakage.
  • Prescription Medications – Some drugs can treat stress incontinence. Anticholinergics can help to control bladder contractions. A tricyclic antidepressant may sometimes be prescribed to help relax the bladder muscle. Side effects from these drugs can include dry mouth, fatigue, and blurred vision. Some people may not be able to take these medications, however.
  • Surgery – Various surgical operations are used to treat stress incontinence. They tend only to be used when pelvic floor muscle exercises have not helped and they aim to tighten or support the muscles and structures below the bladder.
  • Tension-free Vaginal Tape (TVT) Procedure – This is a sling of synthetic (man-made) tape surgically implanted to support the urethra and bladder neck. However recent lawsuits in the US and mounting complaints about pain and tape erosion are concerning to say the least. Colposuspension is another operation to support the urethra and treat stress incontinence.

What can cause stress incontinence?

  • Pregnancy – carrying your baby for nine months takes its toll on your pelvic floor muscles and the extra weight can make them weak. Hormones released during pregnancy can also make your pelvic floor muscles weaker.
  • Childbirth – you can sustain nerve damage during childbirth. If you have a vaginal tear or episiotomy you are more likely to suffer from incontinence.
  • Ageing and the menopause – hormone changes means the muscles, ligaments and fibres supporting your pelvic organs are not as ‘elastic’ as they once were.
  • Overweight – if you are overweight you are TWICE as likely to suffer from stress incontinence. The extra weight is just too much pressure on your pelvic floor.
  • Medication – some medication can contribute to stress incontinence. Statins help to relax your muscles – Woops there goes your pelvic floor again and leaks galore. Anti-depressants can also have the same affect.
  • Smoking – as well as having a 3x higher chance of developing cancer of the bladder, the coughing plays havoc with your pelvic floor. Constant coughing makes your pelvic floor weak which means it will be unable to support your bladder properly resulting in more leaks.

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