If you have had more than one pregnancy and vaginal delivery.
If you have pelvic prolapse. This is when your bladder, urethra, or rectum slide into the vagina. Delivering a baby can cause nerve or tissue damage in the pelvic area. This can lead to pelvic prolapse months or years after delivery.
The main symptom of stress incontinence is leaking urine when you:
Are physically active
Have sexual intercourse
Exams and Tests
Your health care provider will perform a physical exam, including a:
Genital exam in men
Pelvic exam in women
In some women, a pelvic examination may show that the bladder or urethra is bulging into the vagina.
Tests may include:
Cystoscopy to look inside the bladder
Pad test. You exercise while wearing a sanitary pad. Then the pad is weighed to find out how much urine you lost.
Urinary stress test (you stand with a full bladder and then cough)
Urodynamic studies to measure pressure and urine flow
X-rays with contrast dye to look at your kidneys and bladder
Treatment depends on how your symptoms affect your life. Your health care provider may ask you to keep a urinary diary. You can record how many times you urinate during the day and night, and how often you leak urine.
There are four types of treatment for stress incontinence:
Pelvic floor muscle training
Making these changes may help:
Drink less fluid (if you drink more than normal amounts of fluid).
Don't hold it. Urinate when you first feel the urge. This may help reduce the amount of urine that leaks.
Avoid jumping or running.
Take fiber to avoid constipation, which can make urinary incontinence worse.
Quit smoking. This can reduce coughing and bladder irritation. Smoking also increases your risk for bladder cancer.
Avoid alcohol and caffeinated drinks such as coffee. They can cause the urge to urinate.
Lose excess weight.
Avoid foods and drinks that may irritate your bladder. These include spicy foods, carbonated drinks, and citrus.
If you have diabetes, keep your blood sugar under good control.
PELVIC FLOOR MUSCLE TRAINING
There are different ways to strengthen the muscles in your pelvic floor.
Biofeedback. This method can help you learn to identify and control your pelvic floor muscles.
Kegel exercises can help keep the muscle around your urethra strong and working well. This may help keep you from leaking urine.
Vaginal cones. You place the cone into the vagina. Then you try to squeeze your pelvic floor muscles to hold the cone in place. You can wear the cone for up to 15 minutes at a time, two times a day. You may notice improvement in your symptoms in 4 to 6 weeks.
Medicines tend to work better if you have mild to moderate incontinence. Your doctor may prescribe one or more medicine.
Anticholinergic medicines help relax the muscles of the bladder. They include oxybutynin (Oxytrol, Ditropan), tolterodine (Detrol), darifenacin (Enablex), trospium (Sanctura), and solifenacin (Vesicare).
Antimuscarinic drugs block bladder contractions.
Estrogen therapy may help improve symptoms in women who have gone through menopause. It is applied as a cream or inserted into your vagina as a tablet or ring.
Imipramine, a tricyclic antidepressant, helps relax bladder muscles.
If other treatments do not work, your doctor may recommend surgery. Surgery may help if you have severe incontinence. Most health care providers suggest surgery only after trying other treatments.
Anterior vaginal repair helps restore weak and sagging vaginal walls. This is used when the bladder bulges into the vagina (prolapse).
If you have trouble completely emptying your bladder, you may need to use a catheter. This is a very small tube you completely emptying your bladder, you may need to use a catheter. This is a very small tube you place in your urethra to drain urine from your bladder.
Getting better takes time, so try to be patient. Nonsurgical treatments usually improve symptoms. However, they will not cure stress incontinence. Surgery can cure some people with stress incontinence.
Treatment does not work as well if you have:
Conditions that prevent healing or make surgery more difficult
Other genital or urinary problems
Past surgery that did not work
Physical complications are rare and usually mild, but they can include:
Wearing away of materials placed during surgery, such as a sling or artificial sphincter