Stress Incontinence Clinic

Stress incontinence is the commonest form of urinary incontinence and commonly affects females. In fact, one in every three females struggle with urinary incontinence at some point. The condition does not commonly affect men but it can happen.

Most of the people who have stress incontinence also suffer from another condition called urge incontinence. When someone has both urge incontinence and stress incontinence, it is called mixed incontinence. Due to this type of urinary incontinence, you can release urine even when you feel like peeing.

Another type of urinary incontinence is overflow incontinence, due to which you release urine when your bladder is too full or you are unable to completely evacuate it.

Stress incontinence occurs due to sudden pressure on the urethra and the urinary bladder, which result in brief opening of the sphincter muscle inside the urethra so that the urine comes out. Any activity such as coughing, jumping, or sneezing results in squeezing the bladder.

Although urinary incontinence can affect anyone, the problem is more common in those assigned female at birth (AFAB). About half of women above the age of 65 suffer from stress urinary Incontinence, even though the condition is not a normal part of ageing. It indicates a problem that can improve with appropriate treatment. Following are some of the risk factors of stress Incontinence:

• Obesity
• Pregnancy and childbirth, especially normal delivery
• Nerve injuries to the lower back or the pelvis
• Menopause
• Chronic coughing
• Pelvic surgery, like hysterectomy
• Diabetes
• Surgery for enlarged prostate or prostate cancer
• Uterine prolapse

One of the top signs of stress incontinence is the leakage of urine when there is pressure on the bladder. Due to mild stress incontinence, you can leak drops of urine while performing activities like laughing, heavy exercise, sneezing, or coughing.

Moderate to severe stress incontinence can make you release more than a tablespoon of urine even when you are performing less strenuous activity such as bending over or standing up.

Your healthcare provider will ask about your symptoms and perform a complete physical examination. It's better to maintain a bladder diary to monitor your bathroom use, fluid intake, and urine leakage if you suffer from the condition. You can also note down what you were doing before the leakage happened. This will help your doctor understand your condition better and formulate a suitable treatment plan for you.

Following are the tests for stress Incontinence:

• Urinalysis
  This test helps to look for signs of infection in a given sample of urine. It helps determine whether you have blood in your urine or any signs of urinary tract infection. If these signs are present, it may point towards a different problem.
• Urinary pad test
  You are directed to wear an absorbent pad at home for 24 hours. After that, your healthcare provider will weigh the pad to find out how much urine has been leaked.
• Bladder scan
  It refers to a brief ultrasound to determine if you are emptying your urinary bladder adequately when you pee.
• Ultrasound
  An abdominal or pelvic ultrasound is performed to evaluate the health of the kidneys, bladder, and other organs.
• Cystoscopy
  During this procedure, a scope is used by your healthcare provider to examine your urinary tract.
• Urodynamic testing
  It refers to a series of tests performed to gauge how well your urinary system releases or holds urine. It includes a postvoid residual urine test to quantify how much urine is left in the urinary bladder after you pee.

Yes, stress incontinence can be kept under control by performing pelvic exercises as these exercises strengthen the muscles supporting the urinary system. However, strengthening your pelvic floor muscles can be challenging in the beginning. A physiotherapist can help you master the proper techniques. The improvement of symptoms can take four to six weeks.

Apart from pelvic floor exercises, the following steps can help improve the symptoms of stress Incontinence:

• Drink plenty of water and consume high-fibre foods to prevent constipation as it tends to make stress incontinence worse.
• Maintain a healthy weight.
• Quit using tobacco products or smoking.
• Manage conditions like high blood pressure and diabetes.
• Use the toilet at fixed times (timed voiding or bladder training).

Following are some of the treatment options available for women with stress Incontinence:

• Vaginal oestrogen gels, creams, patches, or rings that strengthen vaginal tissues and muscles post-menopause.
• Urethral injections to keep the urethral sphincter closed and bulk up the urethral muscles temporarily.
• Vaginal pessary devices that can be inserted to support the urethra and the bladder.
• Surgery to introduce a sling made of the donor tissue, your own tissue, or surgical mesh beneath the urethra for support.

Men commonly develop stress incontinence post surgery for prostate cancer. Following are the treatment options for stress Incontinence:

• Male sling procedure
  During this procedure, a surgical mesh sling supporting the urethral bulb is introduced.
• Condom catheters
  These catheters cover the penis and drain urine into a bag. Even though these catch the leakage, they don’t prevent it.
• Surgery
  Surgery can be performed to place an artificial sphincter device that closes the urethra until it is opened by pressing a pump when it is time to pee.

Severe stress incontinence can make you feel depressed or anxious and it can be quite embarrassing. Although absorbent urinary pads and adult diapers catch urine leaks, you might feel self-conscious thinking about the odour or worrying about people noticing them. You may not want to be far from a restroom or go out in public. Continuous contact of the skin with urine can irritate it, leading to skin sores and rashes.

Following are some of the steps you can take to reduce your chances of developing urinary Incontinence:

• Lose weight if required and maintain a healthy weight.
• Don’t smoke
• Take steps to prevent constipation
• Practise pelvic floor exercises every day, especially during pregnancy.

The symptoms of stress incontinence can be greatly improved by performing pelvic floor exercises at home and working with a pelvic floor physical therapist. Other treatments can help significantly decrease or stop the leakage of urine if needed.

Following are some of the questions you may want to ask from your healthcare provider:

• What causes stress incontinence?
• What type of urinary incontinence do I have?
• Are there treatments I can try at home?
• What did the test results show?
• What are the risks of surgery?
• Is the surgery right for me?

Depending on how severe your stress incontinence is, leaking urine may be embarrassing or inconvenient. You may feel uncomfortable whenever you are far from the restroom or you may choose to skip exercising for the fear of leaking urine. The symptoms of stress incontinence can be improved by performing pelvic floor exercises regularly. If the stress incontinence is moderate to severe, injections, devices, or surgical procedures can be helpful.

If you are suffering from stress incontinence and are located in Indore, you can visit the Stress Incontinence Clinic at Kokilaben Dhirubhai Ambani Hospital, Indore and fix your appointment with an expert doctor who can guide you to the next step.