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Stress urinary incontinence

Incontinence - stress; Bladder incontinence stress; Pelvic prolapse - stress incontinence; Stress incontinence; Leakage of urine - stress incontinence; Urinary leakage - stress incontinence; Pelvic floor - stress incontinence

Stress urinary incontinence occurs when your bladder leaks urine during physical activity or exertion. It may happen when you cough, sneeze, lift something heavy, change positions, or exercise.

Images

Female urinary tract
Male urinary tract
Stress incontinence
Stress incontinence
Cystoscopy

Presentation

Bladder and urethral repair - series - Normal anatomy

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Causes

Stress incontinence occurs when the tissue that supports your urethra gets weak.

When either set of muscles become weak, urine can pass when pressure is placed on your bladder. You may notice it when you:

Weakened muscles may be caused by:

Stress incontinence is common in women. Some things increase your risk, such as:

Symptoms

The main symptom of stress incontinence is leaking urine when you:

Exams and Tests

Your health care provider will perform a physical exam. This will include:

Tests may include:

Treatment

Treatment depends on how your symptoms affect your life.

There are 3 types of treatment for stress incontinence:

There are no medicines for treatment of stress incontinence. Some providers may prescribe a medicine called duloxetine. This medicine is not approved by FDA for the treatment of stress incontinence.

BEHAVIOR CHANGES

Making these changes may help:

BLADDER TRAINING

Bladder training may help you control your bladder. The person is asked to urinate at regular intervals. Slowly, the time interval is increased. This causes the bladder to stretch and hold more urine.

PELVIC FLOOR MUSCLE TRAINING

There are different ways to strengthen the muscles in your pelvic floor.

SURGERIES

If other treatments do not work, your provider may suggest surgery. Surgery may help if you have bothersome stress incontinence. Most providers suggest surgery only after trying conservative treatments.


Outlook (Prognosis)

Getting better takes time, so try to be patient. Symptoms most often get better with nonsurgical treatments. However, they will not cure stress incontinence. Surgery can cure most people of stress incontinence.

Treatment does not work as well if you have:

Possible Complications

Physical complications are rare and most often mild. They can include:

The condition may get in the way of social activities, careers, and relationships. It also may lead to:

Complications associated with surgery include:

When to Contact a Medical Professional

Contact your provider if you have symptoms of stress incontinence and they bother you.

Prevention

Doing Kegel exercises may help prevent symptoms. Women may want to do Kegels during and after pregnancy to help prevent incontinence.

Related Information

Urinary incontinence
Vaginal itching and discharge - adult and adolescent
Urinary incontinence - injectable implant
Urinary incontinence - retropubic suspension
Urinary incontinence - urethral sling procedures
Urinary incontinence - tension-free vaginal tape
Urinary incontinence - what to ask your doctor
Urinary catheters - what to ask your doctor
Sterile technique
Urinary incontinence surgery - female - discharge
When you have urinary incontinence
Indwelling catheter care
Kegel exercises - self-care
Urine drainage bags
Self catheterization - female
Urinary incontinence products - self-care

References

Al-Mousa RT, Hashim H. Evaluation and management of men with urinary incontinence. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 113.

Kobashi KC, Albo ME, Dmochowski RR, et al. Surgical treatment of female stress urinary incontinence: aua/sufu guideline. J Urol. 2017;198(4):875-883. PMID: 28625508 pubmed.ncbi.nlm.nih.gov/28625508/.

Lucioni A, Kobashi KC. Evaluation and management of women with urinary incontinence and pelvic prolapse. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 112.

Patton S, Bassaly RM. Urinary incontinence. In: Kellerman RD, Rakel DP, eds. Conn's Current Therapy 2022. Philadelphia, PA: Elsevier; 2022:1152-1154.

Resnick NM. Urinary incontinence. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 23.

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Review Date: 1/1/2022  

Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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