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What is stress urinary incontinence (SUI)?

Stress urinary incontinence (SUI) involves the involuntary loss of urine due to increased pressure or force (i.e. “stress”) placed on the bladder. This can occur with a cough, sneeze, jumping, exercise, lifting and other physical activities.

In mild cases of stress incontinence, triggers may be vigorous physical activity such as with exercise, coughing, lifting.

In more severe cases of stress incontinence, even more gentle movements such as walking and standing up can trigger leakage.

What causes Stress Urinary Incontinence (SUI)?

Stress urinary incontinence (SUI) in women is caused by weakness in the muscles that support the bladder (the pelvic floor muscles) as well as weakness of the urethral sphincter (the muscle or valve that holds the urine in the bladder).

This section will focus on the management of stress urinary incontinence in women.

Stress urinary incontinence (SUI) in men is much less common than in women. In men SUI is usually a side effect of treatments for other conditions e.g. prostate cancer surgery (with an operation called radical prostatectomy), and prostate cancer radiotherapy. It is a rare complication after surgery for benign prostate enlargement with TURP (transurethral resection of the prostate or “prostate rebore”).

Different treatment options for male stress urinary incontinence are available compared to women and are detailed in:

How is Stress Urinary Incontinence (SUI) different from Urge Urinary Incontinence (UUI)?

Stress urinary incontinence (SUI) occurs when there is an increase in pressure (or “stress”) on the bladder e.g. with cough, sneeze, exercise.

This is because SUI is caused by a weakness of the support structures of the bladder (such as the pelvic floor) as well as a weakness of the valve at the outlet of the bladder (urethral sphincter which is responsible for holding the urine in the bladder until it is time to urinate).

Urge urinary incontinence (UUI) is unrelated to activity. Leakage is preceded by a sudden and severe desire to pass urine that cannot be delayed. UUI is caused by an abnormality in the nerve supply and muscle function of the bladder.

Many women have mixed urinary incontinence (MUI) that is a combination of SUI and UUI.

How common is Stress Urinary Incontinence (SUI)?

Stress urinary incontinence (SUI) is the most common type of urine leakage that occurs in women. About 1 in 3 women will experience some degree of SUI during their lifetime. Studies of women in the community have found that between 10 to 40% of women are affected by incontinence.

What are the risk factors for developing Stress Urinary Incontinence (SUI) in Women?

In women risk factors for SUI include:

  • Increasing age
    • But SUI can also occur in younger, active, healthy women
  • Pregnancy
  • Childbirth
  • Being overweight or obese
  • Conditions which put chronic strain on the pelvic floor muscles such as
    • Chronic cough
    • Chronic constipation
    • Chronic heavy lifting
  • Genetically inherited factors
  • Nerve injuries to the nerves that supply the pelvic floor and bladder

All of these are things that can result in damage and weakening of the pelvic floor muscles and urethral sphincter (urinary control) mechanism.

What are the effects of Stress Urinary Incontinence (SUI)?

The main impact of SUI is on a person’s quality of life.

While this is not a life-threatening condition, it can gradually erode a person’s confidence and result in increasingly restricted activities- in other words, avoiding doing things that might cause leakage.

SUI can cause people to feel embarrassed and ashamed.

It is important to seek help if stress incontinence is:

  • Restricting the ability to perform daily activities
  • Stopping the ability to play sport
  • Causing unwanted changes in lifestyle
  • A cause of fear about having sex due to fear of leakage
  • Making a person feel uncomfortable about their own body

There are many options for treatment and ways to be helped.

Common myths about Stress Urinary Incontinence (SUI)

Common myths about SUI include believing that:

  • Nothing can be done to help
  • It is a natural part of ageing
  • It can only be corrected by surgery
  • It is just part of being a woman

If SUI is affecting day-to-day life and decisions about how life is lived, it is time to take action. Start by talking to the family doctor and discuss potential treatment options.