Stress Incontinence

What is stress incontinence?
Stress incontinence is the most common form of incontinence, with most cases found in women. It occurs when the bladders valve (the sphincter) is unable to keep closed. This means that when the kegel muscles surrounding the bladder ( the abdomen) contract, urine leaks.

Stress incontinence sometimes occurs when you laugh, sneeze, cough or cause some kind of pressure on the abdomen; however, those with stress incontinence conditions will find themselves experiencing more severe leaking during all times when pressure is experienced.

Stress incontinence tends to occur when the pelvic floor muscles are weakened and rendered incapable at keeping the bladders value shut. Try to image a person holding the value of a balloon full of water shut with two fingers. If the person keeping the value shut were to get tired, the grip on the value would loosen and water would trickle out. This tyring process is similar to that of reflex incontinence.

How common is it?
Stress incontinence is actually the most common form of urinary incontinence.  It is most common in women between the ages of 35 and 60, and 1 in 4 women over the age of 40 will have stress incontinence to some degree.

Stress Incontinence causes?
Largely speaking, stress urinary incontinence is caused by the weakening of the pelvic floor; therefore, the question of what causes stress incontinence actually asks ‘what causes weak pelvic floor muscles’?

The following cause the pelvic floor and the bladder muscles to be weakened, however please note that seeking help from a medical professional is always advised before making an assumption as to what the cause of your stress incontinence is.

There are two mains reasons why pregnancy can often cause urinary stress incontinence. Firstly, and most obviously, a pregnant mother has to carry the extra weight of a baby above the bladder for 40 weeks. Secondly, a hormone called relaxin can cause the bladders value to weaken. Pregnancy can leave the pelvic floor weakened also, which can cause issues for some time after child birth

Childbirth can cause serious problems for the pelvic floor. When a child is born through vaginal delivery, the nerves and muscles around the pelvic floor can be stretched, damaged and bruised. This can prevent the pelvic floor from working properly.

Poor Health:
The extra weight carried when overweight causes extra pressure on the abdomen, which in tern causes extra pressure on the pelvic floor. This has the same effect as pregnancy, weakening the pelvic floor. Being overweight is usually the reason men have stress incontinence, which is actually quite rare.

Smoking can cause chronic coughing fits, which puts extra strain on the pelvic floor. Although this is rare, it can happen and help from a doctor should be sought swiftly.

Medication such as ‘alpha-blockers’ (used to treat high blood pressure), have a known side effect of weakening the muscles that make up the pelvic floor.

Menopause reduces the level of oestrogen in women, which can weaken the muscles pressure around the urethra - leading to more leaks than normal. Menopause is usually a short term problem when relating to stress incontinence.

Treatment, medication and exercises

Luckily for most women, stress incontinence treatment can be through exercise and specialist pelvic floor exercises. In fact, 6 in 10 women who have stress incontinence can be treated this way. If you have stress incontinence, you should see a doctor who can refer you to a specialist in pelvic floor strengthening exercises or a Urodynamics specialist.

It is also possible to beat stress incontinence through lifestyle changes. An example of this would be weight loss. Those overweight can reduce the strain on the pelvic floor muscles by simply loosing weight. Another example is to quit smoking, and treat smokers cough which causes an extra strain on the abdomen.

There are some abstract methods of treating incontinence, which have seen success. Example of this are vaginal weights. Most women feel comfortable with these types of measures, especially when at an early stage of pregnancy.

Stress incontinence surgery may be another option for some, however many tend to attempt exercising the pelvic floor first; however, it can take time for stress incontinence exercises to work (8-12 weeks). Surgery generally attempts to tighten the muscles in the pelvic floor, instead of strengthening them which is achieved through kegel exercises.

Medication is sometimes used to treat problems that have the bi-product of stress incontinence. An example of this is depression, which sometimes causes incontinence and can be treated through the use of medication.

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