Stress urinary incontinence (SUI) is the most common type of urinary incontinence, affecting 15 million women in the United States alone. SUI is the involuntary leakage of urine which occurs during periods of increased intra-abdominal pressure (“stress”). SUI occurs with laughing, sneezing, coughing, exercise, lifting, and other activities.
Other types of urinary incontinence are also prevalent among women although to a lesser degree. These include:
- urge/overactive bladder
- mixed
- overflow
- functional incontinence
You may click here for a full description of the different types of incontinence.
Cause of SUI
The primary cause of SUI is inadequate support of the bladder resulting in leaks during activity. SUI affects women of all ages, including approximately 25% of women age 30-59 years, particularly those who have delivered at least one baby vaginally.
While not a life threatening disorder, SUI diminishes a woman’s quality of life, often limiting her professional, social, sexual, and recreational activities.
SUI Treatment Options
A variety of therapeutic options are available to treat SUI in women. These approaches are broadly divided into non-surgical and surgical treatments, and each category has specific benefits and risks. Click here to view a treatment option table.
There are several non-surgical approaches to the treatment of SUI; however, these often require multiple and repeated treatments over weeks and months to achieve and maintain effectiveness. Some non-surgical treatments, such as urinary plugs and vaginal pessaries, mechanically block urine leakage.
Other therapies, such as Kegel exercises, biofeedback, physical therapy, and pelvic floor electrical stimulation, attempt to strengthen the pelvic floor muscles. These strengthening approaches have limited effectiveness and many women are unwilling or unable to continue performing these exercises consistently over a long period of time.
Bulking agents (which are injected into the urethra to partially obstruct the flow of urine) are not approved by the FDA for the most common form of SUI. Multiple treatments are often required and some agents are associated with a higher incidence of complications than other treatment options.
While the various surgical procedures can be effective for many women, they all pose greater risk than the non-surgical treatments. The most common type of surgical procedures are referred to as “sling” procedures because they involve placement of an implant (known as a “sling”) to support the bladder and urethra.
These treatments range from traditional invasive, open surgical procedures to the more recently introduced, less invasive insertion techniques. All can result in post-operative pain, several weeks of post-operative recovery, and significant costs. Furthermore, some women who have undergone a surgical treatment report continued leaking. Surveys have shown that many women with SUI are not interested in a surgical therapy.(1)
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Reference:
(1) Robinson D, Anders K, Cardoza L, et al. “What Women Want – their
interpretation of the concept of cure.” Journal of Pelvic Medicine & Surgery, Vol.9 Issue 6, pp 273-277, 2003.