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Stress urinary incontinence (SUI)

SUI affects one in three women. Females commonly develop SUI after pregnancy or childbirth due to less support of the urethra. Constipation, obesity, chronic coughing, aging, smoking, or constant heavy lifting can also cause SUI.

 

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 SUI if it impairs their quality of life. SUI is common but not normal if it hinders your active life and there are treatments to help you. 

 

There are several reasons for urine leakage including overactive bladder. 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 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.

 

Additional tests might include:

  • Urinanlysis 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 are sometimes performed to obtain objective data to guide treatment options.

Treatments range from behavioral changes and physical therapy to procedural and surgical options:

 

Lifestyle Changes

  • Urinate prior to physical activities
  • Maintain a normal weight
  • Avoid smoking
  • Treat constipation and reduce straining
  • Avoid heavy lifting

 

Pelvic Floor Physical Therapy

  • Working with a specialized therapist will maximize this option.
  • We have our own physical therapist at Sansum Clinic who is specifically trained in Pelvic Floor Dysfunction ( Taisa Skovorodko, DPT).
  • This option might help improve  SUI symptoms and has no side effects.

 

Urethral Bulking Agent

 

Mid-Urethral Sling Placement

  • An incision at the vagina allows for placement of a mesh sling to support the urethra.
  • It achieves a high success rate with low risk of long term adverse events.
  • More Details about surgical placement of a Urethral Sling