Stress Urinary Incontinence

Urinary Incontinence is a widespread condition that affects one in three Australians. It is a condition that can cause embarrassment, especially when in social situations, which is why it’s a good idea to seek treatment advice.

There are three main types of urinary incontinence: Stress Urinary Incontinence, Urge Incontinence, and Overflow Incontinence. Thankfully, with education, pelvic floor muscle training, and good bladder habits, urinary incontinence can be managed. So, if your quality of life has been affected by this common condition, speak to our pelvic physiotherapists at Sydney Pelvic Clinic for treatment and advice related to the problem.

Stress Urinary Incontinence

Stress Urinary Incontinence refers to bladder leakage during activities that increase pressure in the abdomen and bladder. Coughing, sneezing, laughing, jumping, and lifting activities can all cause the dribbling of urine that occurs when the body is in motion. This happens when the urethra is more mobile and moves away from its position behind the pubic bone during increased pressure on the stomach. This reduces the pressure that ordinarily closes the urethra and therefore urine leaks. This condition can be incredibly debilitating and have a negative effect on the quality of life as sufferers seek to hide the embarrassment of ‘wetting themselves’.

How Common Is Stress Urinary Incontinence?

Stress Urinary Incontinence is the most common type of urinary incontinence in women, accounting for 49-60% of all incontinence cases. It is often caused by a weakness, or stretching, of the pelvic floor muscles and is often associated with vaginal delivery, pregnancy, and menopause.

Stress Urinary Incontinence in men is found after prostate surgery, and it is recommended that men seek healthcare to deal with Stress Urinary Incontinence, as it can take between 6-12 months to resolve the issue following surgery.

Athletic adults, particularly those involved in high-impact sports, are particularly prone to this type of urinary condition due to the impact such sports have on the pelvic floor muscles.

What Are The Common Causes Of Stress Urinary Incontinence?

Contributing factors that put somebody at high risk of developing this condition include:

• High BMI (excess body weight can increase abdominal pressure)
• Age (women at any age can get the condition though it is particularly common in women over 50)
• Strenuous physical activity, exercise and heavy lifting
• Low back or pelvic pain
• Chronic constipation or straining
• Chronic coughing

Other risks for women include number of pregnancies and vaginal deliveries, baby weight over 4kg, forceps delivery and gynaecological surgery, menopause or pelvic prolapse (when the bladder, urethra, or rectum slide into the vagina)

How Is Stress Urinary Incontinence Diagnosed?

At your initial consultation, our healthcare professionals will discuss your symptoms with you, and also explore some of the contributing factors for your Stress Urinary Incontinence. They will assess your bladder behaviour and pelvic floor by carrying out some of the following tests:

• A pelvic floor muscle (PFM assessment)
• A real-time ultrasound
• Women will also have a vaginal exam to check tone, prolapse, defect, and muscle strength. These tests will assess the endurance, elevation and contraction timings of your pelvic floor muscles. They help establish if there are any muscular reasons for your Stress Urinary Incontinence.

How Can I Manage My Stress Urinary Incontinence?

Stress Urinary Incontinence can’t always be avoided but there are things you can do to manage the condition. As examples:

• Drink less fluid (if you regularly drink more than you should)
• Avoid running, jumping, and other activities that could affect bladder control
• Eat more fibre (to reduce constipation which can make the condition worse)
• Avoid caffeinated drinks and alcohol
• Lose excess weight

Treatment For Stress Urinary Incontinence

The main treatment for the condition is pelvic floor exercises, which increase muscle bulk and support. These can be undertaken during activities which usually trigger your muscles, like coughing, sneezing or laughing. These will be discussed with you, alongside education on lifestyle changes, like weight loss or dietary changes, and how to form good bowel habits.

In some cases, surgery to tighten and support the bladder outlet can help, and medication can sometimes be recommended. Such options will be discussed with you after your assessment and will depend on the severity of the condition.

There are also devices that can help provide structural support to the urethra, like a pessary, or a coniform. These help reduce issues with prolapse, which can lead to Stress Urinary Incontinence. A pessary may have topical oestrogen combined, which will require a consultation with your GP.

For more detailed information on Stress Urinary Incontinence and the support we can give you, get in touch with our team of specialists at the Sydney Pelvic Clinic. We are here to help you get both your bladder and life under control again.