Stress Urinary Incontinence
Stress Urinary Incontinence (SUI)
What is SUI?
Stress urinary incontinence
(SUI) is a common condition in which involuntary urine leakage occurs during activities that put pressure on the bladder and pelvic floor muscles
Symptoms
• Urine Leakage - during activities that increase pressure. Ex. coughing, laughing, lifting, exercising, jumping, or standing.
• Triggers - certain movements that puts pressure down on the bladder
• Frequency - can be occasional or more frequent
• No Urgent Urge
• Dependence on Position - may be more noticeable when standing, walking, or engaging in activity that increases abdominal pressure
Risk Factors for SUI:
Gender: SUI is more common in females.
Pregnancy and Childbirth: These can weaken pelvic muscles and structures.
Pelvic or Prostate Surgery: Surgery in this region may affect urinary control.
Smoking/Chronic Coughing: Persistent coughing can increase pressure on the bladder.
Obesity: Extra weight can put pressure on the bladder.
Treatment:
-Pelvic Floor Muscle Assessment
Education
Pelvic Floor Exercises
Biofeedback
Manual Techniques
Core Strengthening
Bladder Training
SUI typically occurs due to weakened or compromised pelvic floor muscles and the supporting structures that help control bladder function.
What is Stress Urinary Incontinence (SUI)?
Stress Urinary Incontinence (SUI) is the involuntary leakage of urine caused by sudden pressure or physical stress on the bladder and urethra. This pressure can result from activities such as coughing, sneezing, laughing, or exercise. The pressure causes the sphincter muscles around the bladder to open briefly, leading to urine leakage.
How is SUI Diagnosed?
To diagnose SUI, you may visit a urologist or urogynecologist, specialists in incontinence. The doctor will ask about your symptoms and perform a physical exam to evaluate your condition. Additional tests may be done to rule out other issues, such as bladder prolapse. You might also be asked to maintain a bladder diary, recording your fluid intake, urination patterns, and any instances of leakage.
Risk Factors for SUI:
Gender: SUI is more common in females.
Pregnancy and Childbirth: These can weaken pelvic muscles and structures.
Pelvic or Prostate Surgery: Surgery in this region may affect urinary control.
Smoking/Chronic Coughing: Persistent coughing can increase pressure on the bladder.
Obesity: Extra weight can put pressure on the bladder.
How is SUI Treated:
Lifestyle Changes:
Empty your bladder regularly (every 2-3 hours) to avoid stress on the urethra.
Maintain a healthy weight and quit smoking.
Treat constipation and avoid straining during bowel movements.
Vaginal Pessary: A silicone device inserted into the vagina to help close the urethra and control urine leakage. It can be removed at any time.
Pelvic Floor Physical Therapy: Strengthening pelvic floor muscles is a proven treatment for SUI. It may take 2 to 4 months of regular exercise to see improvement. Many women benefit from guidance to ensure they are performing the exercises correctly.
Urethral Bulking Agents: A substance is injected near the urethra to help bulk it up and improve control of leakage. This procedure can be done in the doctor's office and is low-risk, though the effects may wear off after a few months.
Surgical Options: Several types of surgery can treat SUI, including mid-urethral suspensions and urethral slings. Surgery is often successful and low-risk, though not all women are candidates. Your provider will discuss which options are best for you.
Medication: Currently, there are no medications specifically for treating SUI. However, if you have mixed incontinence (SUI and overactive bladder), your provider may prescribe medications to treat the overactive bladder symptoms.
Key Points to Remember:
Leaking urine is common, but it is not normal.
Conservative management, including lifestyle changes, pelvic floor strengthening, and the use of pessaries, can significantly improve symptoms.
Consult your provider about surgical options if conservative treatments don't provide relief.
Terminology:
Bladder: A hollow organ that stores urine.
Bladder Diary: A tool to track fluid intake, urination, and leakage.
Incontinence: The loss of control over bladder or bowel functions.
Urethral Sling: A synthetic or tissue-based device implanted to support the urethra and treat SUI.
Urethra: The tube through which urine passes from the bladder out of the body.
Urethral Suspension (Burch): A surgical procedure to suspend the bladder and treat SUI.
Bladder Diary: A record of your fluid intake and leakage patterns.
Bladder Scan: A test to assess proper bladder emptying after urination.
Cystoscopy: A procedure using a tiny camera to inspect the urinary tract for issues.
Urinalysis: A lab test to check for bacteria, blood, or other irregularities in the urine.
Urodynamic Study: A test that evaluates the function of the bladder, urethra, and sphincter muscles.
