Definition of Stress Incontinence

Incontinence is a medical condition in which a person is unable to control urination. Despite its name, stress incontinence is not a psychological or mental issue. Stress incontinence occurs when actions such as sneezing, coughing, heavy lifting, or other activities put pressure on the bladder. This pressure (or stress) forces liquid in the bladder to uncontrollably enter the urethra, which results in involuntary urination. While stress incontinence can affect men, the condition primarily affects women.

Symptoms

• The primary symptom of stress incontinence is uncontrollable urination. Other symptoms of the condition can include embarrassment and a decrease in favored physical activities. According to the Mayo Clinic website, physical activity may not always trigger urinary leakage. However, if incontinence occurs enough to interrupt daily activities, a medical professional may administer a series of tests to determine if the leakage is related to stress incontinence.

Causes

• Stress incontinence is primarily caused by a weakening of the muscles in the urethral sphincter. The urethral sphincter controls the flow of urine, and when pressure is added by the stomach (during movements such as laughing or sneezing) the sphincter does not contract to stop the flow of urine. Stress incontinence can also be caused by neurological injury (in which case an individual cannot recognize the urge to urinate), medications, damage to the urethral region or surgery in the pelvic area in women or the prostate region in men.

Gender Differences

• Women are more susceptible to stress incontinence due to the gradual weakening of the muscles of the pelvic floor due to multiple vaginal childbirths or pelvic prolapse, which occurs when the bladder, rectal tissues, or urethra, protrude into the vaginal cavity. According to the MedLine Plus website, men who have undergone prostate surgery can develop stress incontinence as damage to the urethra and/or urethral sphincter can reduce the strength of the muscles involved in urination.

Risk Factors

• In addition to vaginal childbirths for women and prostate surgery for men, there are additional situations that can contribute to the development of stress incontinence. According to the MedLine Plus website, those who are elderly may experience stress incontinence as well due to the weakening of muscles throughout the body. Frequent coughing from respiratory conditions such as emphysema, asthma, or bronchitis can cause stress incontinence as coughing puts pressure on the stomach muscles, which put pressure on the bladder. According to the Mayo Clinic website, another risk factor for stress incontinence is obesity, as excess weight can also put stress on the bladder and contribute to stress incontinence.

Treatments

• There are a variety of options available for the treatment of stress incontinence. According to the MedLine Plus website, there are four categories of treatment options for stress incontinence: behavioral changes, pelvic floor muscle training, surgery and medication.
  Behavioral changes include fluid consumption changes (drinking less overall daily or drinking less caffeine and alcohol), healthy lifestyle changes (such as losing weight if obese or quitting smoking) and urination scheduling (in which a doctor prescribes urinating more during the day to keep the bladder empty).
  Pelvic floor training is another name for Kegel exercises, those which focus on developing the muscles in the pelvic floor. There are a number of surgical options available for both men and women, which focus on reinforcing the bladder or strengthening the closure of the urethral sphincter.
  Depending on the cause of stress incontinence, there are a number of drugs that treat weakness of the urethral sphincter as well as medications that prevent the contractions of the bladder that cause urine leakage.