Stress Urinary Incontinence

Stress Urinary Incontinence (SUI) is the involuntary leaking of urine and one of the most common and easily cured reasons for urinary leaking. 

 What is it?
In essence, it is due to physical stress or external pressure on the bladder with increased pressure in the abdomen. For example, laughing, coughing, sneezing and lifting all involve strong abdominal contractions that place significant pressure on the bladder. Running, changing directions quickly and jumping all involve higher impact and displacement of the bladder with similar results. Leaking occurs when the muscles of the pelvic floor are not able to react appropriately to close off the urethra and thus allows urine to escape. 
What are the causes?
Most often it is caused by dysfunction of the pelvic floor muscles which can be from any of the risk factors discussed in this post "Everyday things that can put your pelvic floor at risk": 

 Most notably: 

  • Excessive straining with bowel movements or ongoing constipation
  • High impact activities or repetitive lifting without adequate pelvic floor strength and stability
  • Pregnancy - with the extra weight of a baby on your pelvic floor for the better part of 9 months!
  • Vaginal delivery with a long pushing phase >2hrs 
  • Perineal tears with a vaginal delivery
  • Pelvic surgery

What can be done about it?
Prevention: Avoid constipation, ensure optimal strength of your pelvic floor if you are a runner, weight lifter or cross-fit enthusiast. Consult a pelvic health physio pre-natally to appropriately prepare your pelvic floor for pregnancy and delivery to minimise post-natal complications. 

 Pelvic Health Physiotherapy: Strengthening and optimising the function of your pelvic floor muscles is key to curing and preventing urinary incontinence. However, we now know that pelvic floor muscle dysfunction is the result of what is happening throughout the entire body. A physiotherapist can also assess the muscles to determine the cause of the dysfunction, whether it is simply due to weakness or if there is also spasm and tightness of the muscles preventing them from functioning optimally. 

 Pessary:  A pessary is an insert that fits into the vagina and is most often used in the management of prolapse in conjunction with physiotherapy. However, they can also be beneficial in severe cases of SUI with a specific knob that helps to put external pressure on the urethra to stop leaking.

 Surgery: The most common current procedure for SUI is Tension-Free Vaginal Tape (TVT)  which helps provide extra support to the urethra under stress. As with any surgery, there are associated risks and should always be considered as the final option. It is not a guaranteed cure as every body responds differently and success is optimised by working with a pelvic health physiotherapist before and after the surgery.
If you have any questions, please feel free to leave a comment or use the contact form to the left :)

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