Stress Urinary Incontinence
Explore Stress Urinary Incontinence therapy options.
What is Stress Urinary Incontinence?
Stress Urinary Incontinence affects 43% of U.S. women. Females commonly develop Stress Urinary Incontinence after pregnancy or childbirth due to less support of the urethra. Constipation, obesity, chronic coughing, aging, smoking, or constant heavy lifting can also cause Stress Urinary Incontinence.
The bladder holds urine as it fills up like a balloon. Acute pressure from vigorous activity or other stress events like sneezing unintentionally pushes urine through the urethra. The urethra is the tube that carries urine out of the body from the bladder.
Some women rarely leak, for example, only when sick with a cough, lifting occasional heavy objects or when the bladder has not emptied recently. Many leak with common activities such as laughing or walking. Women often limit themselves both physically and socially to avoid stress urinary incontinence. These females should consider treatment for their Stress Urinary Incontinence if it impairs their quality of life. Stress Urinary Incontinence is common but not normal if it hinders your active life. There are treatments to help you.
How is Stress Urinary Incontinence Diagnosed?
There are several reasons for urine leakage, including an Overactive Bladder (OAB). A careful voiding history is obtained about when and how often you leak urine, including what makes the symptoms worse. A physical exam will be performed to check for pelvic organ prolapse and the ability to contract the pelvic floor. Also, you will be asked to cough or strain to see if you leak with a full bladder.
Additional tests might include:
Urinanalysis to check for a urinary tract infection and blood in your urine.
Ultrasound or placement of a small catheter to assess how much urine remains in your bladder.
Urodynamics is rarely performed to obtain objective data to guide treatment options.
How is Stress Urinary Incontinence Treated?
The first step in treating stress urinary incontinence is an initial office evaluation for urine leakage or bladder symptoms. Once the symptoms are diagnosed, there are four therapy options to consider.
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Lifestyles changes is a conservative management therapy for Stress Urinary Incontinence. This therapy includes:
• Urinating before physical activities
• Maintaining an average weight
• Avoiding smoking
• Treating constipation and reduce straining
• Avoiding heavy lifting
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Pelvic floor physical therapy is a conservative management therapy for Stress Urinary Incontinence. Pelvic floor physical therapy with a trained, specialized professional could maximize the benefits of this therapy.
This therapy might help improve Stress Urinary Incontinence symptoms and has no side effects.
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The Bulkamid bulking procedure is a minimally invasive treatment option. The Bulkamid procedure is very low-risk and allows you to return to your daily activities the next day.
The Bulkamid procedure:
• The brief procedure is performed using just light sedation
• A gel is injected at the urethra using a small cystoscope
Bulkamid bulking benefits include:
• Bulkamid is a gel that is 97.5% water
• Bulkamid has been safely used in plastic surgery for >10 years
• 67% of women were cured or significantly improved at 7 years
• 81% of women were satisfied at 7 years, requiring no further therapy
• <10% of women have immediate poor emptying requiring placement of a foley catheter which is removed the next morning
Short term risks such as discomfort, UTI and bleeding are rare
• 0% of women have long-term complications
• There are no post-procedure activity restrictions
• The procedure can be repeated to improve the results
• Repeat or “top-up” procedures occur <10% of the time at the Bladder Boutique
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A mid-urethral sling results in urethral support with sudden bladder pressure. The sling supports like a hammock to prevent leakage with activity. Despite excellence efficacy, some women not wanting a mesh sling may choose a more invasive surgery with an “autologous” sling at a hospital to avoid possible mesh sling complications. An “autologous” sling is made from a woman’s own abdominal wall or leg.
The sling surgery:
• A mesh sling is surgically placed in the outpatient setting
• The mesh sling is placed by incising the vagina to put the foreign body around the urethra below the bladder
• The surgery is done with deep sedation or under general anesthesia
• Risks of the surgery include mesh extrusion, mesh erosion, bleeding, infection, difficulty emptying &/or pain
• Although not common, these risks can result in long-term complications
• There are post-procedure activity restrictions for 2 to 6 weeks