Stress Urinary Incontinence (SUI) is the involuntary leakage of urine during activities such as coughing, sneezing, lifting, laughing, or exercising. SUI is a common problem for women, affecting one in three over the age of 45, but there are a number of effective treatments.
Tanaz Ferzandi, MD, MBA, MA, Director of Urogynecology and Pelvic Reconstructive Surgery at Tufts Medical Center outlines the the most common treatment options for stress urinary incontinence below. One of these options, or a combination of these options, may help improve symptoms and quality of life. That said, treatment of stress incontinence depends on how severe your symptoms are and how much they affect your day-to-day life. Please talk to your doctor before deciding on any treatment plan.
1. Behavior Changes
Behavior changes are simple, self-directed, and are often used in combination with other treatment options. Possible behavior changes include:
- Moderating fluid intake during the day
- Urinating on a scheduled basis
- Avoiding jumping or running
- Avoiding alcohol and caffeine
- Losing weight if overweight
- Avoiding food and drinks that could irritate the bladder
2. Pelvic Floor Muscle Training
Also known as “Kegel exercises,” these exercises can strengthen your urinary sphincter and pelvic floor muscles. These exercises can both improve stress incontinence, and prevent the condition from worsening. They can also help suppress the urge to urinate. In order to see tangible results, exercises must be done regularly and with the correct technique. Sometimes, it might help to initiate the program with specialized trained physical therapist.
3. Vaginal Pessary
A pessary is a ring-shaped silicone device inserted into the vagina. Pessaries push the urethra closed to help control urine leakage and allow you to urinate normally throughout the day. Some women wear a pessary only when exercise, but others leave it in, depending on when their symptoms are most bothersome.
4. Urethral Bulking Agents
This procedure involves a substance injected into the urethra to “bulk up” the walls at the bladder neck. This is an outpatient procedure and is typically performed in the office. The procedure is low risk, allows you to be active immediately, but may need to be repeated after several months.
Surgery is only recommended after the cause of the incontinence is known. It is generally used as a last-step solution, after behavior changes or muscle training. Surgical options include:
- Retropubic Colposuspension: Sutures are attached to ligaments or bone to lift and support tissues near the bladder and upper urethra.
- Sling procedure: The most common procedure for women with stress incontinence. A permanent sling is created to support the urethra, all done vaginally. This is an outpatient procedure.
If you experience stress incontinence, Tufts Medical Center’s Division of Urogynecology and Pelvic Reconstructive Surgery in downtown Boston specializes in treatment plans for this condition. Our all-female staff, comprised of fellowship-trained and board-certified urogynecologists, wants you to know that you have safe and effective treatment options. Our physicians see patients in Boston, Norfolk, Braintree and a new location in Wellesley.
International Urogynocological Association. “Stress Urinary Incontinence: A Guide for Women.” <https://www.augs.org/assets/1/6/SUI.pdf>
American Urogynocologic Society. “Stress Urinary Incontinence.” <https://www.iuga.org/resource/resmgr/brochures/eng_sui.pdf>