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What is it?

Stress urinary incontinence (SUI) is defined as urinary leakage that occurs with sudden pressure on the urethra/bladder from movement or activity such as coughing, laughing, sneezing, standing from a seated position, bending over, running, or jumping.

Prevalence

It is estimated that at least 1 in 3 women will experience SUI at some point in their lives.

Cause

The urethra is a tube that drains urine from the bladder to outside the body. It has sphincteric pelvic floor muscles that keep it closed, helping to keep us continent of urine. When urinary leakage occurs, the pelvic floor muscles and soft tissue are not able to counteract the downward pressure from above and the sphincter muscles momentarily open, releasing urine. The pelvic floor muscles and soft tissue may become compromised due to a variety of reasons:         

• Pregnancy/delivery
• Aging and the change in hormones
• Chronic coughing
• Chronic constipation or diarrhea
• Chronic heavy lifting
• Smoking
• Being overweight
• Nerve injuries to the low back
• Pelvic surgery

Effect on Daily Life

SUI can greatly affect every area of life, including work, social and romantic relationships, and hobbies/activity level. Some people become isolated or feel embarrassed, not even wanting to discuss this problem with their health care provider.

Ask yourself whether leaking urine or the fear of leaking urine has:

• Stopped you from doing things outside of your home?
• Caused you to be afraid to be too far from a bathroom or a change of clothes?
• Stopped you from exercising or playing sports?
• Changed the way you live because you’re afraid of leaks?
• Made you uncomfortable with yourself and your body?
• Changed your relationships with friends or family?
• Made you avoid sex because you are worried that you will leak urine and be embarrassed?

If you answered yes to some of these questions, please know that there are many options to manage and treat SUI. (Questions taken from Urology Care Foundation)

Conservative Treatment

• Pelvic floor muscle training
  • Strengthening in the form of pelvic floor muscle contractions (kegels). Learn more about pelvic floor muscle contractions here https://torontopessaryclinic.com/the-pelvic-floor-what-is-it/.
• Pelvic floor relaxation
  • Sometimes the pelvic floor muscles are so tight and contracted that they can’t generate the force needed to keep you continent when you experience sudden bursts of downward pressure on the bladder. In these situations, once the muscles learn to relax and lengthen, they are able to provide sufficient strength and closure around the urethra to maintain continence.
• The Knack
  • Sometimes the muscles are sufficiently strong, but they lack coordination. In this case, timing training can help to prevent urinary leakage with coughing, laughing, sneezing, etc. Check out our blog on the knack https://torontopessaryclinic.com/what-is-the-knack/.
• Pessary
  • When you have addressed any pelvic floor dysfunction as best as possible, but you still experience urinary leakage, a pessary can be considered. A pessary is a removable, silicone device inserted into the vagina to provide a little extra pressure on the urethra to keep it closed, so as to reduce the occurrence of urinary leakage. Read more about pessaries https://torontopessaryclinic.com/what-is-a-pessary/

Invasive Treatment

• Injectable bulking agents
• Surgery- a variety of surgical options are available

If you experience SUI and would like to explore conservative treatment options, give us a call. We do pelvic floor muscle training and specialize in fitting pessaries to help you better manage symptoms of SUI and reclaim your quality of life!

The information in this blog is provided as an information resource only and should not be used as a substitute for seeking personalized direction from your overseeing physician. Please consult your healthcare team before making any decisions about your pessary treatment plan, which is unique to you and your overall health. Toronto Pessary Clinic expressly disclaims responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this blog.