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Stress Urinary Incontinence: Causes, Diagnosis & Treatment Options
DR ALPHY S PUTHIYIDOM 15 May 2024
What is Stress Urinary Incontinence (SUI)?
Have you ever laughed a little too hard and felt an unexpected leak? Or maybe a sneeze caught you off guard? If so, you’re not alone. Stress urinary incontinence (SUI) is the involuntary leakage of urine triggered by activities that put pressure on the bladder—things as simple as coughing, sneezing, laughing, or even exercising. While common, especially among women, it’s not something you have to just live with.
Recognizing the Symptoms
SUI can sneak up on you, but here are some signs to watch for:
- Leakage during physical activities like running, lifting, or jumping.
- Involuntary urine loss when sneezing, coughing, or laughing.
- Worsening symptoms over time, particularly after childbirth or with aging.
- A sense of incomplete bladder control that disrupts daily life
What Causes Stress Urinary Incontinence?
SUI happens when the muscles and tissues that support the bladder and urethra weaken. Some common culprits include:
- Pregnancy & Childbirth: The stretching of pelvic muscles during vaginal delivery can lead to long-term weakness.
- Aging & Menopause: Reduced estrogen levels cause tissue atrophy, making bladder control more difficult.
- Obesity: Extra weight puts added pressure on the bladder, making leaks more likely.
- Chronic Coughing: Whether from asthma or smoking, frequent coughing strains the pelvic floor.
How Do We Diagnose Stress Urinary Incontinence?
A visit to a urogynecologist can help confirm SUI with:
- Medical History & Symptom Review
- Pelvic Examination: Checking muscle strength and support.
- Urine Tests: To rule out infections or other underlying issues.
- Urodynamic Testing: Measuring how well the bladder holds and releases urine.
- Pad Test or Cough Stress Test: Observing leakage when coughing or straining.
Treatment Options: Finding the Right Solution for You
The best treatment depends on how severe the symptoms are and personal preference. The good news? There are multiple options available.
1: Pelvic Floor Physiotherapy: Strengthen from Within
Think of it as a workout for your bladder muscles. Kegel exercises and specialized physiotherapy can help tighten and retrain the pelvic floor. Techniques include:
Biofeedback Therapy: Using sensors to track muscle strength and guide improvement. Electrical Stimulation: Gently activating the muscles to improve function.
Bladder Training: Learning better control techniques to reduce leaks.
2: Minimally Invasive Surgical Treatments: Long-Term Solutions
For women who need more than physiotherapy, surgical procedures can offer lasting relief.
- TVT (Tension-Free Vaginal Tape) & TOT (Transobturator Tape) These procedures use a thin mesh sling to support the urethra and prevent leakage. They boast success rates of 80-90%. The procedure is minimally invasive and typically performed as a day surgery under local or general anesthesia. Recovery is relatively quick, with most women resuming normal activities within a few weeks. Possible risks include: temporary discomfort, difficulty urinating for a short period, and in rare cases, mesh complications such as erosion or infection. However, modern techniques and experienced surgeons minimize these risks significantly. Overall, most women experience a significant improvement in bladder control and quality of life.
- Bulkamid Injection: A Simple Fix? A gel-like substance is injected into the urethra to bulk it up and reduce leaks. Ideal for mild to moderate cases. Quick recovery but may require repeat treatments over 5-7 yrs time.
3: Laser Therapy: Does It Really Work?
Vaginal laser treatments, like CO2 and Er:YAG lasers, have been advertised as a non-surgical fix for SUI. But do they really help?
Studies have shown mixed results.
The FDA has issued warnings against unproven claims.
While some women report improvement, the scientific evidence isn’t strong enough to recommend lasers as a first-line treatment.
The Bottom Line: You Don’t Have to Live with SUI
Stress urinary incontinence is treatable, and you don’t have to suffer in silence. Whether it’s pelvic floor therapy, minimally invasive surgery, or injectable treatments, there are solutions to help you regain control and confidence.
If you’re struggling with SUI, don’t wait—speak with a urogynecologist to find the best treatment option for you.
Dr. Alphy S puthiyidom is a Minimally Invasive Gynecological and Pelvic Reconstructive Surgeon specializing in treatments for urogynecology and pelvic floor disorders. Book a consultation and take the first step toward a leak-free life.
Dr. Alphy S Puthiyidom
MBBS, MD(Obs&Gn),FMIS(Laparoscopy)
Head of the Department Obstetrics & Gynecology
Advanced Gynecological Laparoscopic Surgeon
& Pelvic Reconstructive Surgeon
MEDICLINIC WELCARE HOSPITAL
Al Garhoud, Dubai
MEDICLINIC PARKVIEW HOSPITAL
Umm Sequim, Al Barsha South 3, Dubai
Appointments 800-1999