Stress incontinence

Stress incontinence means that you leak a small amount of urine when you do something that puts stress, strain, or pressure on your bladder. It can happen when you cough, laugh, strain, lift something, or change position.

The main symptom of stress incontinence is the leaking of urine when you sneeze, cough, laugh, lift something, change position, or do something that puts stress or strain on your bladder. With this type of bladder control problem, you may leak a small to moderate amount of urine.

Your doctor will ask you about your health history. You'll be asked how often and how much you urinate and leak urine. Your doctor will also do a physical exam and check a sample of your urine. Other tests may be needed to make sure your incontinence isn't caused by another condition.

Stress incontinence can be treated with:

• Pelvic floor muscle exercises (Kegels). These help strengthen the muscles that control the flow of urine.
• Diet and lifestyle changes. For example, limit caffeine, carbonated drinks, and alcohol. They make you urinate more.
• Medicines. An antidepressant medicine may help with bladder control. Estrogen cream may be used in the vagina. This may help with bladder control.
• Medical devices. These include:
  • Urinary catheter. This includes condom catheters.
  • Penile clamp. This may work for short-term use.
  • Incontinence pessary. This fits into the vagina and compresses the urethra.
• Injections of material around the urethra (urethral bulking). This can help prevent leaking.
• Surgery. This is done to put in a perineal or urethral sling to support, lift, or compress the urethra. This makes you less likely to leak urine when you sneeze, cough, or laugh. Surgery can be very effective, but it has risks. When deciding whether to have surgery, talk about the risks and benefits with your doctor.

There are products, like pads and disposable underwear, that absorb urine.

• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Limit caffeine, carbonated drinks, and alcohol. They make you urinate more.
• Try pelvic floor (Kegel) exercises, which tighten and strengthen pelvic muscles. (If doing these exercises causes pain, stop doing them and talk with your doctor.) To do Kegel exercises:
  • Squeeze your muscles as if you were trying not to pass gas. Or squeeze your muscles as if you were stopping the flow of urine. Your belly, legs, and buttocks shouldn't move.
  • Hold the squeeze for 3 seconds, then relax for 5 to 10 seconds.
  • Start with 3 seconds, then add 1 second each week until you are able to squeeze for 10 seconds.
  • Repeat the exercise 10 times a session. Do 3 to 8 sessions a day.
• Prevent constipation. Make sure you drink enough fluids and include fruits, vegetables, and fiber in your diet each day.
• If you're overweight, talk to your doctor about safe ways to lose weight. Losing weight can help with stress incontinence.
• Wearing pads that absorb the leaks may help for a time. Pads designed to absorb urine work best.
• Keep skin in the genital area dry. Petroleum jelly (like Vaseline) spread on the area may help protect your skin.