About Stress Urinary Incontinence (SUI)

Incontinence is the involuntary loss of urine, a symptom with many causes. Stress incontinence is a type of leakage that occurs with increased abdominal pressure which can happen with coughing, sneezing, laughing, straining or lifting. Severe degrees of stress incontinence can be caused by even minor physical movements.

Stress incontinence can be related to poor support of the urethra, lack of urethral function, or combinations of both. Determining the cause can be key to choosing the best options for your treatment. Treatment selection can and should be tailored to the individual. At Minnesota Urology, we assess your medical history combined with a physical examination and other tests to help decide what the best treatment options are for you.

• What are risk factors for SUI?

  Genetics, aging, obesity, smoking, pregnancy, chronic cough (bronchitis and asthma) and childbirth can all play a role in causing SUI. Although SUI is much more common in women, men can also have the same problem, usually as a complication of prostate surgery.

• Is it really a problem?

  Yes! Urinary leakage is not a normal condition and is often the source of discomfort and embarrassment. It can lead to restricted physical activity and enjoyment of everyday life. Knowing that your mother, sister or friend has stress incontinence and chooses to ignore it does not mean that you have to do the same. The myth that incontinence is normal and a part of the aging process is false! For most patients, the sooner that they deal with the condition, the better. While a treatment may not completely eliminate all leakage, it can still make a big difference. If you find yourself altering or avoiding daily activities that you once enjoyed, you need our help. At Minnesota Urology, it is our goal to give you options and to provide you with safe and successful solutions.

• What can be done about SUI?

  There are several different approaches depending on the specifics of your condition. These include behavioral interventions such as diet and exercises, or treatments guided by a therapist such as biofeedback or physical therapy. Unlike for urge incontinence, there are no medications that are frequently used to treat SUI. Other options such as surgery can be very successful, and the procedures vary depending on the particulars of your problem and your own choices.

• What should I expect when I come for an appointment?

  First you need to make an appointment! We can’t help you if you do not confront the problem. To start, we will take a specialized history and perform a careful physical examination. If you have had prior surgery for incontinence, it will be important to discuss. Details of prior procedures, along with a list of your current medications and your completion of a bladder diary that will be given to you prior to your first appointment can be very helpful. At your first appointment, we will determine if the leakage can be seen during examination, if there is any evidence of other common female conditions such as prolapse, how well you are emptying your bladder, and if you can perform a Kegel exercise. For most women, initial treatment options will be based on these factors. However, some patients require more testing to pinpoint their individual issues leading to leakage, e.g., X-rays, urodynamics (bladder function testing) or cystoscopy (looking inside the bladder with a telescope).

• What is conservative treatment?

  Most women are aware that Kegel exercises, exercises of the pelvic floor muscles, can help with symptoms of urinary leakage. In order to be most effective, they need to be done correctly. We can offer a comprehensive program which includes biofeedback and/or physical therapy, to help you optimize your success with conservative options.

• What is the surgical treatment?

  Surgery can be the right choice for SUI. The procedures that we most often offer for this problem are the simplest, safest, and most successful in history. They include mid-urethral and fascial slings and injection of bulking agents into the urethra. In the majority of cases, when SUI is the only problem being corrected, the procedures are performed under “twilight anesthesia” as an outpatient. They are usually not very painful, don’t require catheters, and can have immediate benefits. Patients often may return to work within several days and resume normal activities within a month. Though no option is 100% effective for everyone, the most common comment we hear is, “I wish that I would have done this a long time ago!”