The weakening of multiple muscles and tissues around the urethra that support the urethra and control the passage of urine cause Stress incontinence.

The weakening of these muscles can be due to the following:

• Prostate surgery: A surgery to remove the prostate gland is performed in men to treat prostate cancer, and this is the most commonly observed cause of Stress incontinence. The surgery may weaken the sphincter, which surrounds the urethra and is just below the prostate gland.
• Giving birth: If there is tissue or nerve damage during child delivery, it can decrease the pelvic floor muscle strength. You may not experience Stress incontinence soon after delivery, but sometimes the symptoms might start showing years later.

Apart from these causes, which are the major contributors to the condition, other factors may also lead to a worsening of Stress incontinence, and these include:

• Chronic coughing
• Obesity
• Smoking, which eventually leads to coughing
• Intense physical activities like jumping and running over the years

If you are experiencing Stress incontinence, you might involuntarily pass urine while:

• ● Exercising
• ● Lifting heavy things
• ● Sneezing
• ● Coughing
• ● Bending over

It is not necessary that every time you perform one of these actions, you experience Stress incontinence. It usually happens when the bladder is full, and the activity creates pressure on the bladder.

Stress incontinence does not usually warrant any additional tests. Your doctor, however, may prescribe few tests to evaluate the urethra, bladder, and sphincter; generally, referred to as urodynamic tests.

Some of these tests are listed below:

• Post-void residual urine test: If the doctor is concerned about your ability to empty your bladder, especially in cases of older age, diabetes, or a history of bladder surgery. The test determines whether the bladder is functioning well or not.

The doctor will use an ultrasound scan (translation of sound waves in an image format) to determine the urine left in the bladder immediately after you urinate. In some cases, a catheter (slim tube) is inserted through your urethra into the bladder to drain out the urine and measure it.

• Measurement of bladder pressure: If you have had a history of neurological disease(s) in the spinal cord, the doctor might ask you to go for a Cystometry and perform this to measure the pressure in the region surrounding the bladder and in your bladder itself.

A catheter slowly fills up the bladder with fluid. After that, to check for leaks, the examiner may ask you to bear down or cough. A pressure flow study may be conducted with this procedure to determine the pressure that the bladder needs to exert to empty totally.

• Imaging the bladder as it functions: Video urodynamics creates images of the bladder while it is emptying and filling. During this, they add a dye to the warm fluid that is readable by the X-ray and then, using a catheter, fill up the bladder while the X-ray records images. It continues recording as the bladder is full, and you urinate to empty your bladder once again.
• Cystoscopy: This is a procedure performed generally in the doctor’s office. In this procedure, a scope is inserted in your bladder to check for any abnormality or blockage.

There are multiple ways practiced to treat Stress Incontinence. If the doctors identify that this is due to any underlying condition, they may treat the issue as well, along with stress incontinence.

1. Behavioral Therapies: These are non-medical ways of getting the solution via exercises and changing habits. The expert may recommend:

• Exercises like Kegel Exercise, which is a great way to strengthen your urinary sphincter and pelvic floor muscles.
• Monitoring your fluid consumption includes intervals as well as the constituents of the fluids. For example, the doctor might ask you to avoid having alcoholic, caffeinated or carbonated drinks as these may disturb bladder function.
• Lifestyle and habitual changes, like losing excess weight and quitting smoking
• Following a schedule for emptying the bladder reduces the severity of the urge incontinence.

2. Devices: There are a few devices that may prove useful to monitor the symptoms of stress incontinence in women:

• Vaginal Pessary: This is a ring-shaped device with two bumps that fit on each side of the urethra. It is a customized pessary for stress incontinence, fit by the doctor. This device especially is helpful if your bladder has prolapsed (dropped), as it prevents leakage by supporting the bladder base. This is a better alternative to skip surgery; however, it requires regular cleaning.
• Urethral Inserts: It is a small disposable device like a tampon. It has to be inserted into the urethra to block any leakage; generally, used for physical activities like heavy lifting, sports, etc. However, they can last for eight hours, and you can use them throughout the day.

The treatments mentioned above, among various others, may considerably reduce or even completely resolve Stress incontinence. If you still have mild symptoms, you can take necessary precautions like:

• Using incontinence pads
• Making yourself aware of the toilets at your destination
• Seat yourself in a way that you can access the toilets quickly

These treatments will, in most cases considerably, reduce and even eliminate urine leakage. Although, sometimes, you might still have urine leakage in certain situations or while performing certain activities.