Stress Urinary Incontinence – Dr. Lubna Razzak
SUI is when urine leaks out with sudden pressure on the bladder and urethra causing the
sphincter muscle to open briefly.
With mild SUI, pressure may be from sudden forceful activities, like with exercising, sneezing,
laughing or coughing. If your SUI is moderate or more severe, you may also leak with less
forceful activities, like standing up, walking or bending over. These leaking “accidents” can be a
few drops to enough to soak through clothes.
About 1 in 3 women have this problem at some point in their lives.
Causes SUI
The most common risk factors for SUI are:
• Gender: females are more likely to get SUI
• Pregnancy and childbirth
• Pelvic surgery
• Chronic coughing
• Smoking (which leads to chronic coughing)
• Being overweight
Signs and Symptoms
To know if SUI is a problem for you, ask yourself:
• Am I afraid to be too far from a bathroom or a change of clothes?
• Have I stopped exercising or playing sports?
• Have I changed the way I live because I m afraid of urine leakage?
• Have I become uncomfortable with myself and my body?
• Have my symptoms changed my relationships with friends or family?
• Am I avoiding sex because I am worried that I will leak and become embarrassed?
If you answer yes to some of these, you should know that there is hope.
Treatment
There are many ways to manage and treat SUI.
There are both nonsurgical and surgical options.
Lifestyle Changes
You can lose weight, stop smoking (to help you cough less) and maintain good overall health,
you can reduce leaks.
Pelvic Floor Muscle Exercises Also known as Kegels. Daily Kegels are proven to strengthen your
pelvic floor, which supports the bladder and other organs. By exercising these muscles
(consciously contracting and releasing pelvic floor muscles daily) you will make them stronger
to prevent urine loss. It’s important to do these exercises correctly and often.
MEDICAL TREATMENT:
At this time there are no drugs approved in the FDA to treat SUI.
SURGICAL TREATMENT
If surgery is suggested, there are many options. You can work with your doctor, with experience
in SUI surgery.
Learn the risks and benefits, and what to expect during and after surgery.
Options of surgery
Slings surgery
The most common surgery for SUI in women is “sling” surgery. For this, a small strip of material
(a sling) is placed under your urethra and stops it from moving downward during activities. It
acts as a hammock to support the urethra and the neck of the bladder. Many sling techniques
have been developed. The mid-urethral sling is the most common type of surgery to correct
SUI. The sling is a narrow strip of synthetic mesh. It is placed under the urethra. There are a lot
of techniques used, such retropubic, transobturator and single-incision.
Urethral Injections/ Bulking Agents
“Bulking agents” are injected into the urethral sphincter to improve the way the sphincter
closes.
Bladder Neck Suspension
It is also called Retropubic Suspension, Colposuspension, or Burch Suspension and is not as
common as sling surgery.
The goal of any treatment for incontinence is to improve your quality of life. Surgical
treatments usually work, especially when combined with lifestyle changes. In most cases, great
improvements and even the cure of all leaks are possible for people who choose SUI surgery.
REFERENCES
Surgical treatment of female stress urinary incontinence: AUA/SUFU guideline. 2017
EAU guidelines on urinary incontinence. 2017.
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