Definition of "Stress incontinence"

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Stress [urinary] incontinence (aka effort incontinence) is due to insufficient strength of the closure of the bladder.

Patient information

What is stress incontinence?
It's where, whenever you put physical stress on your body, you wet yourself. This happens because there's not enough strength to close the bladder.

What's the bladder?
It's the body part that stores urine.

Pathophysiology
  • It is due to insufficient strength of the pelvic floor muscles [to support the sphincters] to prevent the passage of urine
  • It is especially evident during activities that increase intra-abdominal pressure (e.g. coughing, sneezing, exercising)

Patient information

Why does the part that stores urine in the body, leak?
It's weakness in the sphincters, that control exit of urine from that storage area. This in turn is supported by pelvic floor muscles.

What is the pelvic floor?
They're muscles that span the underneath of the pelvis.

Cause
  • Weakness in pelvic floor muscles, due to, in women:

Patient information

Why do you get weak pelvic floor muscles?
Child birth. Things in the pelvis falling out, known as pelvic organ prolapse.

Mx

Stress incontinence: →​ related to the pelvic floor muscles

  • Pelvic floor training w/ PT, such as Kegel exercises, is first line Tx. Success rate is 35%
  • Bladder training, involving efforts to increase time between urination
  • Electrical stimulation, to strengthen pelvic floor muscles
  • Reducing intraabdominal pressure, through weight loss, cease smoking
  • Surgery, success rate is 85%, including:
    • Bladder sling, a mesh/tape which goes underneath the bladder and holds the bladder muscles in place, replacing the support lacking from these muscles
    • Tension-free vaginal tape
    • Bladder suspension

Patient information

What can you do about stress incontinence?
Pelvic floor exercises. Bladder training. You can also try lifestyle things, lke losing weight, stop smoking. If all that fails, you can do surgery.

See also
  • Urinary incontinence (category)

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Definition of Stress incontinence | Autoprac


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