Stress Incontinence

Stress incontinence is an involuntary loss of urine that occurs during physical activity, such as coughing, sneezing, laughing, or exercise. In stress incontinence, the sphincter muscle and the pelvic muscles, which support the bladder and urethra, are weakened. The sphincter is not able to prevent urine flow when there is increased pressure from the abdomen (such as when you cough, laugh, or lift something heavy).

Stress incontinence may occur as a result of weakened pelvic muscles that support the bladder and urethra or because of a malfunction of the urethral sphincter. The weakness may be caused by:

• Injury to the urethral area
• Some medications
• Surgery of the prostate or pelvic area

Stress urinary incontinence is the most common type of urinary incontinence in women. Stress incontinence is often seen in women who have had multiple pregnancies and vaginal childbirths, and whose bladder, urethra, or rectal wall stick out into the vagina (pelvic prolapse).

Risk factors for stress incontinence include:

• Being female
• Childbirth
• Chronic coughing (such as chronic bronchitis and asthma)
• Getting older
• Obesity
• Smoking

Symptoms

The main symptom of stress incontinence is involuntary loss of urine. It may occur when:

• Coughing
• Sneezing
• Standing
• Exercising
• Engaging in other physical activity
• Engaging in sexual intercourse

Urge Incontinence

Urge incontinence is leakage of urine due to bladder muscles that contract inappropriately. Often these contractions occur regardless of the amount of urine that is in the bladder.

Urge incontinence may result from:

• Bladder cancer
• Bladder inflammation
• Bladder outlet obstruction
• Bladder stones
• Infection
• Neurological diseases (such as multiple sclerosis)
• Neurological injuries (such as spinal cord injury or stroke)

In most cases of urge incontinence, no specific cause can be identified. Although urge incontinence may occur in anyone at any age, it is more common in women and the elderly.

Symptoms

• Frequent urination, in the daytime and at night
• Involuntary loss of urine
• Sudden and urgent need to urinate (urinary urgency)