The Burden of Stress Urinary Incontinence (SUI)

If is often considered “a part of life” when we leak a little with a good laugh, sneeze or while exercising. However, stress urinary incontinence can take a major toll on our emotional and social lives.

Published Dec 5, 2019

Columnist

J.Adderton, BSN, MSN

121 Articles; 502 Posts

Specializes in Clinical Leadership, Staff Development, Education.

Do you ever feel like you are charting on auto pilot? With electronic “point and click” charting it is easy for documentation to become more standardized than individualized. When assessing the GU system, our documentation is often limited to continent or incontinent. It’s easy to forget there are different types of incontinence that impact a person’s life at varying levels. Bladder Health Awareness Month is a great opportunity to learn more about the most common type of incontinence, Stress Urinary Incontinence (SUI).

What is SUI?

Do you ever experience urine leakage when you exercise, cough, laugh or sneeze? SUI is caused by sudden pressure on the bladder that causes the sphincter muscles to open briefly, allowing urine to leak out. The urine amount may be a few drops or enough to need a change of clothes. In severe cases, simply standing bending or walking can lead to embarrassing leaks.

Statistics

Approximately 1 in 3 women will experience SUI at some point in their lives. The risk increases with age and

About one-third of women age 60 report sometimes leaking urine
About 50% of women age 65 and older report sometimes leaking urine
Over half of women with SUI also have an Overactive Bladder

Men do have SUI, but prevalence rates are for lower than women. Causes of SUI in men are likely due to prostate surgery or pelvic nerve damage.

SUI and Menopause

Oestrogen is a female hormone that helps the urethra to seal after urinating by maintaining thickness of the urethra’s lining. Unfortunately, production is slowed after menopause, leading to SUI in some women.

SUI can occur in younger women and men, although it impacts older women the most. Some young women experience SUI after pregnancy and childbirth, which typically improves over time. Other risk factors include:

Obesity
Smoking
Chronic cough
Lower back nerve injuries
Pelvic surgery
Prostate surgery

Impact on Quality of Life

The prevalence of SUI is likely under reported due to the embarrassment experienced by people with incontinence. Fear of leaking urine can have a negative impact both emotionally and socially, such as

Being reluctant to leave home
Stopping you from activity you enjoy, such as exercising
Changing the way you live
Making you uncomfortable with your body
Changed relationships with family and friends
Making you avoid sex or changed your sex life

It may be easy to feel isolated when the fear of being too far away from a bathroom keeps you from doing things you enjoy.

Treatment

The treatment plan for SUI will depend on a person’s symptoms and the impact on daily life. Both surgical and nonsurgical options are available to treat SUI. Let’s take a closer look at several treatment options available for women, pelvic floor exercises, lady partsl inserts, electrical stimulation and surgery. The goal of all SUI treatments is to strengthen muscles that support the GU system organs and pelvic floor.

Lifestyle Changes

There are lifestyle changes that can be made to help minimize urine leakage.

Pelvic Floor Exercises (Kegel)

These self-directed exercises can be done by women anytime and won’t cause any side effects. By squeezing and relaxing the pelvic floor muscles multiple times a day, symptoms of SUI can be greatly reduced.

For additional pelvic floor exercises, visit the following websites:

Pelvic Floor Exercises for Women

Pelvic Floor Exercises for Men

Other lifestyle changes that can help with SUI include:

Maintain a good bowel pattern to prevent constipation
Maintain a healthy weight (losing just 10lbs can help with leaks)
Start a smoking cessation program

lady partsl Inserts

Pessaries are lady partsl devices that are inserted into the lady parts and press against the lady partsl wall and urethra. They help reposition the urethra and/or uterus, leading to fewer leaks. There are different types of pessaries from disposable over-the-counter devices to fitted specifically to a woman’s anatomy.

Electrical Stimulation

Low-grade electrical currents may be used to stimulate weak pelvic muscles to contract. A tampon-like device is inserted into the lady parts and a handheld device is used to adjust the current. Units are available for home sessions and may be covered by insurance.

Surgery

Surgical interventions are aimed at restoring the normal position of the bladder neck and urethra. However, effective these procedures are is often debated in the medical community.