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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.

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Female urinary tract
Male urinary tract
Stress incontinence
Stress incontinence

Presentation

Bladder anatomy

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Causes

Stress incontinence occurs when the muscles that control your ability to hold urine get weak or do not work.

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 health care 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.

If you have trouble completely emptying your bladder, you may need to use a catheter. This is a very small tube you place in your urethra to drain urine from your bladder.

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 some 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

Call 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

American Urological Association website. Surgical treatment of female stress urinary incontinence (SUI): AUA/SUFU guideline. www.auanet.org/guidelines/stress-urinary-incontinence-(sui)-new-(aua/sufu-guideline-2017). Accessed April 6, 2018.

Hashim H, Abrams P. Evaluation and management of men with urinary incontinence. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 72.

Kobashi KC. Evaluation and management of women with urinary incontinence and pelvic prolapse. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 71.

Resnick NM. Incontinence. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 26.

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Review Date: 1/23/2018  

Reviewed By: Sovrin M. Shah, MD, Assistant Professor, Department of Urology, The Icahn School of Medicine at Mount Sinai, New York, NY. Review provided by VeriMed Healthcare Network. 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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