Stress urinary incontinence (SUI) is the most common form of urinary incontinence and affects up to 48% of women over 18 years of age.1 It occurs when the bladder leaks urine during physical activity or exertion like coughing, running or lifting something heavy. Women experience SUI when the muscles that support the bladder, like the pelvic floor and sphincter, weaken, making them more vulnerable to unintentional leakage.2 There are different types of urinary incontinence. Women may also experience urge incontinence or overactive bladder (OAB), which is marked by a strong need to urinate that cannot be controlled.1 And in many cases, women will experience both OAB and SUI at the same time, known as “mixed incontinence.”2 SUI differs from OAB by affecting the urethra, rather than just the bladder. OAB strictly affects the bladder organ, while SUI occurs when the pelvic floor/urethra muscles are not strong enough to hold the urine in, so any additional pressure on the pelvis could cause a leak. There a several causes and risk factors that make women more likely to experience SUI:
While pregnancy and childbirth are a leading cause of SUI, it’s a common condition that affects many women at different stages of life. Childbirth is a leading contributor as it can cause the pelvic floor muscles to weaken due to pressure and possible nerve damage during delivery. Women may seek treatment for SUI between pregnancies, but additional pregnancies can cause repeat incidences of SUI.
Pelvic surgeries like hysterectomy and nerve injuries to the lower back can also weaken the same pelvic floor muscles, leading to SUI.2
Risk Factors 4
- Age - the likelihood of experiencing any type of urinary incontinence, whether SUI or OAB, tends to increase with age.
- Being Overweight - excess weight increases pressure on the abdominal and pelvic organs.
- Smoking- smoking can lead to chronic cough that results in pressure to the bladder.
The primary symptom of stress urinary incontinence (SUI) is bladder leakage, but what distinguishes SUI from Overactive Bladder (OAB) is the activity that precedes the leak. If a woman is experiencing SUI, she will leak urine during high-impact activities that put forceful pressure on the bladder and urethra. These activities include:
- Standing up or getting out of a car
- Heavy Lifting
- Physical Activity
- Having sex
When a person has mild SUI, leaking occurs during these more forceful activities, while moderate to severe instances of SUI can trigger leaks during much less strenuous activities, like standing up or bending over.4
It is common for women with SUI to have mixed incontinence, which means they also experience symptoms of overactive bladder (OAB). For these women, leakage is also associated with an urgency to urinate that often leads to accidents.2
- The Prevalence of Urinary Incontinence, Victor W. Nitti, MD, Reviews in Urology, June 2001. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1476070/.
- Mayo Clinic. Stress Incontinence. Symptoms and Causes. https://www.mayoclinic.org/diseases-conditions/stress-incontinence/symptoms-causes/syc-20355727. Accessed March 27, 2019.
- Urinary Incontinence. Office on Women’s Health. https://www.womenshealth.gov/a-z-topics/urinary-incontinence. Accessed March 27, 2019.
- Urology Care Foundation. The Official Foundation of the American Urological Association. https://www.urologyhealth.org/urologic-conditions/stress-urinary-incontinence-(sui). Accessed March 27, 2019.
- Mayo Clinic. Stress Incontinence. Diagnosis & Treatment. https://www.mayoclinic.org/diseases-conditions/stress-incontinence/diagnosis-treatment/drc-20355732. Accessed March 27, 2019.