What is the definition of Stress Urinary Incontinence (SUI) ?

Stress incontinence happens when physical activity — such as coughing, sneezing, running or heavy lifting — puts pressure (stress) on your bladder. It is not related to psychological stress.

In what Situations can SUI Occur ?

• Cough

• Laugh

• Sneeze

• Standing up

• Get out of a car

• Lifting something heavy

• Exercise, especially abdominal exercises

• Sexual activity

One may not experience incontinence every time, but any pressure-increasing activity can make one more vulnerable to urine leak, particularly when the bladder is full.

Factors that increase the risk of developing stress incontinence include:

Age. Although SUI isn't a normal part of ageing, physical changes such as the weakening of muscles, may make one more susceptible to stress incontinence. However, occasional stress incontinence can occur in women of any age.

Type of childbirth delivery. Multiple vaginal deliveries and Forceps assisted deliveries are associated with higher rates of the later development of stress incontinence.

Body weight. People who are overweight or obese have a much higher risk of stress incontinence. Excess weight increases pressure on the abdominal and pelvic organs. Weight loss can improve stress urinary incontinence.

Previous pelvic surgery. Hysterectomy in women and particularly surgery for prostate cancer in men can alter the function and support of the bladder and urethra, making it much more likely for a person to develop stress incontinence. This effect can be either immediate or delayed.

Complications of stress incontinence may include:

Personal distress.

Skin rash or irritation.

Treatment

Your Urologist may recommend a combination of treatment strategies to end or lessen the number of incontinence episodes. If an underlying cause or contributing factor, such as a urinary tract infection, is identified, you'll also receive treatment for the condition.

Behaviour therapies

Behaviour therapies may help you eliminate or lessen episodes of stress incontinence. The treatments your doctor recommends may include:

• Pelvic floor muscle exercises. Kegel exercises strengthen your pelvic floor muscles and urinary sphincter. Your doctor or a physical therapist can help you learn how to do them correctly. Just like any other exercise routine, how well Kegel exercises work for you depends on whether you perform them regularly.

• Fluid consumption. Your doctor might recommend the amount and timing of fluids you consume during the day. Your doctor also may request that you avoid caffeine (tea / coffee / cold drinks) and alcoholic beverages to learn how these dietary irritants affect your bladder function. If using fluid schedules and avoiding dietary irritants significantly improves leakage, you'll have to decide whether changing your fluid consumption pattern or giving up coffee or alcohol is worth the improvement in leakage.

• Healthy lifestyle changes. Quitting smoking, losing excess weight or treating a chronic cough will lessen your risk of stress incontinence as well as improve your symptoms.

• Scheduled toilet trips. Your Urologist might recommend a schedule for toileting (bladder retraining) if you have mixed incontinence. More frequent voiding of the bladder may reduce the number or severity of urge incontinence episodes.

Devices and Surgeries are the options, which your surgeon may suggest to you.

Lifestyle and home remedies

Healthy lifestyle practices can ease symptoms of stress incontinence. These include:

• Shed extra weight. Moderate weight loss may markedly improve your stress incontinence especially if BMI > 25 to start with

• Add fiber to your diet. If chronic constipation contributes to your urinary incontinence, keeping bowel movements soft and regular reduces the strain placed on your pelvic floor muscles. Try eating high-fiber foods — whole grains, fruits and vegetables — to relieve and prevent constipation.

• Avoid foods and beverages that can irritate your bladder. If you have mixed incontinence and you know that drinking coffee or tea tends to make you urinate and leak more frequently, try eliminating that drink, especially on days you really don't want to be bothered by leakage.

• Don't smoke. Smoking can lead to a severe chronic cough, which can aggravate the symptoms of stress incontinence. Smoking is also associated with a drop in your oxygen-carrying capacity, a factor thought to increase the risk of an overactive bladder. And smoking is associated with bladder cancer.