Stress incontinence

Definition

Stress incontinence is an involuntary loss of urine that occurs during physical activity, such as coughing, sneezing, laughing, or exercise.

Alternative Names

Incontinence - stress

Causes

The ability to hold urine and control urination depends on the normal function of the lower urinary tract, the kidneys, and the nervous system. You must also have the ability to recognize and respond to the urge to urinate.

Stress incontinence is a bladder storage problem in which the strength of the muscles (urethral sphincter) that help control urination is reduced. The sphincter is not able to prevent urine flow when there is increased pressure from the abdomen.

Stress incontinence may occur as a result of weakened pelvic muscles that support the bladder and urethra or because of a malfunction of the urethral sphincter. The weakness may be caused by:

• Brain or nervous system (neurological) injury
• Injury to the urethral area
• Some medications
• Surgery of the prostate or pelvic area

Stress urinary incontinence is the most common type of urinary incontinence in women.

Stress incontinence is often seen in women who have had multiple pregnancies and vaginal childbirths, and whose bladder, urethra, or rectal wall stick out into the vagina (pelvic prolapse).

Risk factors for stress incontinence include:

• Being female
• Childbirth
• Chronic coughing (such as chronic bronchitis and asthma)
• Getting older
• Obesity
• Smoking

References

Holroyd-Leduc JM, Tannenbaum C, Thorpe KE, Straus SE. What type of urinary incontinence does this woman have? JAMA. 2008;299:1446-1456.

Rogers RG. Clinical practice. Urinary stress incontinence in women. N Engl J Med. 2008;358:1029-1036.