What Is It?
There are several types of urinary leakage (urinary incontinence) including urge leakage, stress leakage, and mixed leakage.
Stress urinary leakage is caused by increases in abdominal pressure which result in leakage of urine. Increases in abdominal pressure occur when laughing, coughing, sneezing, or physical exertion using the abdominal musculature.
The problem appears more commonly in women than men. The source of the problem is often weakness of the muscles at the base of the pelvis.
Age and gender may also be factors. Stress leakage tends to appear in older women. In fact, 35% of women over 60 years of age report some degree of stress leakage.
Symptoms of Stress Urinary Leakage
The most obvious symptom is urinary leakage when the body undergoes stress, like during a cough or lifting a heavy weight.
Obesity is also a contributing factor. Pregnant women sometimes experience stress leakage due to the increased pressure on the bladder as the mother comes to term.
Evaluation and Treatment
A thorough history and physical examination often points to cause of urinary leakage. A voiding diary can be valuable to ascertain when, where, and how much urine has leaked. When the cause of leakage is not certain, a urodynamic test may be offered to evaluate the bladder further. This test is performed in the clinic setting.
Treatments range from behavior modification, exercises to strengthen the muscles of the pelvis and urethra (kegel exercises), as well as minimally-invasive outpatient surgery (urethral sling).