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What is Stress Urinary Incontinence?

What is Stress Urinary Incontinence?

 

Stress urinary incontinence is the involuntary release of urine during laughter, coughing, lifting of objects or any movement that increases pressure on your bladder.

 

Urine is composed of water, electrolytes, and other waste material that has been filtered out of the blood in your kidneys. Urine is then transported via the ureters to your bladder, where it is stored. Once full, the muscles in the wall of your bladder contract forcing urine through the urethra and out of your body. Sphincter muscles and pelvic floor muscles keep the urethra closed to avoid leakage of urine. These muscles relax at the same time the bladder contracts in order to allow urine to exit your body.

 

What Causes Stress Urinary Incontinence?

It is caused by a lack of support to the bladder outlet, this is due to both pelvic floor and connective tissue weakness.  These tissues act like a hammock to resist the downward pressure on the bladder during increased abdominal pressure e.g.- when coughing

 

There are several causes for stress urinary incontinence, these include:

Hormonal changes

During the week before your menstrual cycle, estrogen levels fall, causing symptoms of stress urinary incontinence to worsen. Additionally, as a woman goes through menopause, estrogen levels also fall causing the pelvic floor muscles to weaken. This results in less muscular pressure around the urethra, making stress urinary incontinence more likely.

Pregnancy 

If you are pregnant, you may experience stress urinary incontinence due to hormonal changes and the enlarging size of the uterus.

During pregnancy, estrogen levels are lower, leading to less muscular strength in the sphincter and pelvic floor muscles. Additionally, as the fetus grows extra weight is placed on your bladder.

Childbirth    

Vaginal delivery can damage your pelvic floor muscles making urine leakage more likely. The supporting tissues of your bladder can also be damaged during vaginal delivery causing a cystocele, or prolapse of your bladder, symptoms of which include urinary incontinence. You may not know you have suffered damage to your pelvic floor until after you have gone through menopause, when the pelvic floor muscles are further weakened due to a fall in estrogen levels.

Poor exercise choices

Hysterectomy and other surgery

Some exercises will exacerbate a week pelvic floor, these include running, jumping or any high impact exercise.  Other exercises which stress the pelvic floor include sit-ups and deep lunges.

The bladder and uterus are very close together and have common supporting ligaments and muscles. Surgery to, or removal of your uterus as in a hysterectomy, risks damage to the supporting structures of your bladder. If these supporting structures are damaged, a cystocele is likely to occur. Symptoms of a cystocele include urinary incontinence.

Illnesses    

When you are ill and suffering from severe coughing, the pelvic floor muscles may fatigue and allow temporary stress incontinence due to an increase in abdominal pressure experienced while coughing.

Obesity

Obesity can increase the abdominal pressure on the bladder leading to urinary incontinence.

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