Stress Urinary Incontinence Jordin Lang West Coast University Urinary Incontinence is defined as leakage of urine that is involuntary. Stress Urinary Incontinence is involuntary urine leakage that is due to weakened pelvic floor muscles. It is most commonly found to be a greater problem in women. Estimates say that upwards of 35% of women 65 and older experience some form of urinary incontinence. Stress incontinence is an involuntary loss of urine that happens because of physical activity, like coughing, sneezing, laughing, or exercise.
The strength of the pelvic floor muscles is inadequate to support the urinary tract under pressure. The anatomy of the urinary system involved in continence in women includes the bladder, urethra, pelvic floor muscles and sphincter. Urine is stored in the bladder which fills like a balloon to accommodate up to two cups of urine. When a woman urinates the muscles surrounding the bladder contract to squeeze the urine out. Pelvic floor muscles support the uterus, bladder and rectum. There are also many nerves some of which send the signal to the brain that one needs to urinate.
What occurs with stress urinary incontinence is that the sphincter and pelvic floor muscles when weakened cannot support the closure of the urethra when increased pressure from the abdomen occurs. Such as coughing, sneezing, laughing or exercising. (“Medlineplus stress incontinence,” 2011) Many women under the age of 65 develop issues with stress urinary incontinence following pregnancy and childbirth. Vaginal deliveries and episiotomies often result in stress urinary incontinence that is temporary and frequently clears up o its own within six weeks following delivery.
In addition to pregnancy and childbirth some women may experience stress urinary incontinence during menopause. Estrogen keeps the lining of the bladder and pelvic floor plump and healthy, when estrogen decreases during menopause, some women may develop mild urinary incontinence a result. Risk factors for developing stress urinary incontinence include, being female, childbirth, increasing age, chronic coughing such as occurs with chronic bronchitis and asthma, multiple childbirths, obesity and smoking. (“Merkmanual: Polyuria,” 2011)
Diagnosis of stress urinary incontinence is made after assessment of symptoms and in some women a pelvic exam will reveal the bladder or urethra bulging into the vaginal space. Tests may possibly include cystoscopy (inspection of the interior of the bladder), a “pad test”, pelvic or abdominal ultrasound and tests to measure post-void residual (amount of urine left after urination). Urinalysis is usually performed as well in order to conclusively rule out urinary tract infection. Health care providers may also perform a q-tip test to measure the angling of the urinary tract when resting and under pressure.
An angle of greater than 30 degrees suggests significant pelvic floor weakening. There are three major modes of treatment for stress urinary incontinence. The first is pelvic floor muscle training and behavioral changes such as smoking cessation, losing weight and abstaining from alcohol and excess caffeine. Medications such as anticholinergic drugs, antimuscarinic drugs that block bladder contractions, alpha adrenergic agonist drugs also have been known to aid in the tautness of the urinary sphincter muscles. Surgery is often only indicated after all other treatments have failed.
Anterior vaginal repair and retropubic repair are most common surgeries to treat severe stress urinary incontinence. (“Medlineplus stress incontinence,” 2011) Stress Urinary incontinence is surely a troublesome and perhaps embarrassing ailment. An ailment that can most definitely can interfere with a patient’s quality of life. With proper medical treatment, prognosis is generally good. References Medlineplus stress incontinence. (2011). Retrieved from http://www. nlm. nih. gov/medlineplus/ency/article/000891. htm Merkmanual: Polyuria. (2011). Retrieved from