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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Adult and Senior Health Stress incontinence

Stress incontinence

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Stress incontinence is an involuntary loss of urine that occurs during physical activity like coughing, sneezing, laughing or exercise. It is the common type of urinary incontinence in women.

 

The ability to hold the urine and control urination depends on the normal function of the lower urinary tract, the kidneys and the nervous system.

It occurs due to problem in the bladder storage in which the strength of the muscles that help to control urination is reduced. The sphincter is unable to prevent urine flow when there is increased pressure from the abdomen.

Stress incontinence is seen in women who had multiple pregnancies and vaginal child births.

It may occur due to weakened pelvic muscles which help to control the urination.  The weakness may be caused by

  • Brain or nervous system injury
  • Injury to the urethral area
  • Medications
  • Surgery of the prostate or pelvic area

Risk factor for stress incontinence

  • Females
  • Child birth
  • Chronic coughing like asthma, chronic bronchitis
  • Old age
  • Obesity
  • Smoking

Signs and symptoms

Involuntary loss of urine is the main symptom. It occurs when ther ei s

  • Coughing
  • Sneezing
  • Standing
  • Exercising
  • Engaging in other physical activity

Tests and diagnosis

  • Pelvic examaintion in females
  • Cystoscopy
  • Pelvic or abdominal ultrasound
  • Urine analysis or urine culture
  • Electromyogram
  • X-rays of kidney and bladder
  • Urinary stress test
  • Urodynamic studies
  • Cystometrogram
  • Uroflometry

Treatment

  • Behavioral changes
  • Medications
  • Pelvic floor muscle training
  • Surgery.
  • Pelvic floor exercises or Kegel exercises
  • Electrical stimulation
  • Antimuscarinic block bladder contractions
  • Alpha-adrenergic agonist like phenylpropanolomine and pseudoephedrine helps to increase sphincter strength and improve the symptoms
  • Estrogen therapy is used in postmenopausal women
  • Bladder neck suspension procedures
  • Collagen injection to the periurethral injection
  • Anterior vaginal repair or paravaginal repair if there is cystocele
  • Artificial urinary incontinence

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