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Stress Incontinence

Stress incontinence is a common cause of bladder leakage in a woman, especially as her age increases or after childbirth. There are other types of incontinence also, like urge incontinence, functional incontinence, mixed incontinence and overflow incontinence.

Stress incontinence is the leaking of urine during activities that put pressure on the bladder like coughing, sneezing, laughing, exercising, lifting heavy objects or having sex.

Causes

Stress incontinence is often the result of weakened or damaged pelvic floor muscles and tissues which provide support to the bladder and urethra. This weakening of muscles may be caused by

  • Pregnancy and Childbirth: vaginal deliveries can stretch or damage pelvic floor muscles

  • Ageing and menopause: decreased levels of estrogen can weaken pelvic muscles

  • Obesity

  • Pelvic surgeries like hysterectomies can damage the pelvic support structures

  • Chronic coughing due to smoking or other respiratory conditions

  • Pelvic prolapse where the bladder, urethra or rectum slide into the vagina, which can damage the muscles of the pelvic floor

Management and Treatment

The damage to pelvic floor muscles can occur during pregnancy and childbirth. Providing physiotherapy during this period can help women to prevent this leakage from the bladder.

Lifestyle changes:

  • lose weight to reduce pressure on the bladder.

  • Bladder irritant diet like spicy food, carbonated drinks, caffeine, chocolates, highly processed foods, and refined grain products can be avoided.

  • A bladder friendly diet like fruits in a range of colors, various vegetables, whole grains, and calorie-dented nutrients to maintain optimum weight can be recommended.

  • Stop smoking, alcohol intake and take measures for chronic cough.

  • Avoid constipation

  • Avoid weight lifting

Pelvic floor exercises (kegel exercises) can strengthen the pelvic muscles and can improve control over leakage

Bladder training

Pessaries and vaginal cones

Medications are not normally recommended , however estrogen creams locally may help in the post-menopause period.

Surgery: if stress incontinence is affecting day-to-day activities, for better quality of life, surgery can be recommended.