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Ways to manage stress urinary incontinence

Ways to manage stress urinary incontinence

Limiting water intake, peeing before going out and keeping the bladder half full are the ways to avoid stress urinary incontinence

stress urinary incontinence

While nobody talks about it openly, many people, while jumping, running or coughing, accidentally pass urine. This condition is called stress urinary incontinence (SUI.)

“Any stress on the abdomen can lead to a urinary leak. This is called SUI,” says Dr Ketan Vartak, professor of urology, Bharati Vidyapeeth’s Medical College, Pune Maharashtra.

Causes of stress urinary incontinence

According to experts, this is a condition that is very common among women.

Dr Vartak says that the reasons for SUI are many – weakness of the pelvic floor muscles, multiple labours and vaginal deliveries. “Women also have a shorter urethra when compared to men. Ageing could also lead to the weakening of pelvic floor muscles. Because of this, many elderly women live with SUI,” he points out.

Dr Deepak Dubey, consultant, urology at Manipal Hospital, Bengaluru explains how pregnancy can change the structure of the muscles. “The baby is down in the lower abdomen and presses against all the tissues in the pelvic area; this leads to stretching and loosening of the tissues. This, in turn, leads to involuntary urination,” he says.

And for a woman who has given multiple births, her pelvic floor muscles become loose. This automatically weakens the support structure of pelvic organs.

Dr Manohar T, chief of urology and renal transplant surgeon, Apollo Hospitals, Bengaluru tells Happiest Health that SUI, apart from old age, could also be caused by atrophic vaginitis (inflammation of the vaginal wall due to less estrogen in the body), multiple surgeries and old age. In all these cases, the muscles tend to weaken.

According to doctors, menopause could also make women more vulnerable to developing the condition.

Symptoms of stress urinary incontinence

The symptom of SUI is pretty clear – urinary leakage. “It (SUI) can be divided into various grades – mild, moderate and severe,” says Dr Manohar.

In mild SUI, there are two to three droplets of urine leaking when a person sneezes or laughs. In moderate SUI, urine leakage is more than mild. In severe cases, a person involuntarily wets the undergarment.


Apart from analysing the apparent (urine leakage), ultrasound examinations (sonography), tests like bladder stress test and Bonney test can be done to check the urine flow patterns and identify urine retention capacity.


Dr Manohar says that SUI might lead to bacterial and fungal infections and excoriations (abrasions) of the skin due to leakage of urine on undergarments. “There is a social stigma attached to SUI, which is unfortunate. People living with SUI may feel embarrassment as they reek of urine,” he says.


Bacterial infection during pregnancy

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Prevention and treatment

Exercising after childbirth is key to preventing the condition, says Dr Manohar. He advises pelvic floor exercises and regular exercises for six to nine months. According to Dr Vartak, pelvic floor exercises can be done 400-500 times a day. “The more a woman exercises, the better the outcome,” he says.

Harvard Health explains how to do pelvic exercises:

  • Contract your pelvic floor muscles for three to five seconds.
  • Relax for three to five seconds.
  • Repeat the contract/relax cycle ten times.

To prevent urine leakage, it is also essential to keep a check on one’s weight. “Women should manage weight, as the weight is transmitted to the lower part of the body, leading to SUI,” says Dr Dubey.

The other factor to keep in mind is the consumption of water. “The leaks occur when the bladder is full. Thus, women with SUI should reduce their water intake when necessary. When the bladder is half-empty, urine leaks don’t occur as there is no volume,” says Dr Vartak.

According to National Health Service, UK, altering fluid intake, that is drinking too much or too less fluid, makes SUI deteriorate.

Dr Vartak also points out that women can reduce water intake when they are out in public places, or they can empty their bladder before stepping out to prevent the urine from leaking.

For those living with SUI, Dr Manohar advises pelvic floor exercises. “The exercises will help strengthen the pelvic floor muscles.”

In the case of moderate SUI, along with pelvic exercises, doctors prescribe medicines to manage it. “Medications are given to increase the tone of the muscles and prevent the overactivity of the bladder,” says Dr Manohar.

To treat severe SUI, bladder and urethral surgery are usually performed.

Measures to mind

Dr Vartak says that women who cannot opt for surgery due to underlying conditions or age can go for pessary (a device placed in the vagina that supports the bladder, urethra and vagina) and absorbent products like pads and artificial compression device (balloons) to resist the pressure of full bladder.

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