Stress urinary incontinence: advice for patients

Stress urinary incontinence (SUI) is the involuntary loss of urine which can occur on effort or physical exertion, on sneezing, coughing, or jumping. It is one of the most common lower urinary tract disorders for which women seek medical attention.

SUI in adult women may be caused by defects in the urethra, neurological conditions, or weakened muscles. These may come about from childbirth, pregnancy, obesity, ageing and surgery.

There are no approved medications for SUI.

These are things that you can do to help symptoms:

• Weight management
• Avoiding triggers (such as heavy lifting and impact exercise)
• Stopping smoking
• Managing constipation, as straining to poo weakens your pelvic floor muscles and makes urinary incontinence worse.
• Managing fluids: Drink 6 to 8 glasses (which is 1.5 – 2.0 litres) of fluid a day unless your doctor advises you otherwise.
• Cutting down on caffeine: as certain drinks containing caffeine such as coffee, tea, hot chocolate, and fizzy drinks can irritate the bladder.
• Cutting down on alcohol
• Avoiding certain foods: spicy or acidic foods can irritate the bladder.
• Core stability exercises like Pilates. These are exercises that can strengthen the core muscles which include the pelvic floor.

Please watch the video below for details about bladder function and stress incontinence

These are things that Physiotherapy management may involve:

• Guided Pelvic floor physiotherapy exercises for strengthening of the pelvic floor.
• The knack: squeezing the pelvic floor muscles before actions that would cause leaks.
• Biofeedback (verbal or visual feedback on technique) and electrical stimulation (making the muscles stronger using a device).
  

Others:

• Pessaries: devices inserted into the vagina that provide mechanical support. These can be provided through the GP or the Gynaecology team.
• Topical vaginal oestrogen. This can be prescribed by a GP.