Stress urinary leakage (stress incontinence)

Overview

Weak pelvic floor muscles or a weak urethra let urine leak when pressure in the belly rises.

It's different from urge incontinence, which is a sudden strong need to pee.

Symptoms

Common signs:

• Leaking urine when coughing, sneezing, laughing, or lifting

Less common

• Leaking with exercise

When to get medical care

Causes

Weak pelvic floor from childbirth, menopause, aging, obesity, chronic cough, or prostate surgery.

Does it spread or run in families?

• It isn't contagious. You can't catch it from someone else.

Who is more likely to get it

• Vaginal childbirth
• Menopause
• Obesity

Diagnosis

A healthcare professional asks about leaks.

Questions you may be asked

• When leaks happen
• Births and surgeries

The exam

A pelvic exam.

Tests

Tests, if needed:

• Urine test:
• Bladder diary:

Treatment

Most people improve with exercises.

Self-care

• Do Kegel exercises: squeeze the muscles that stop urine, hold 3 to 5 seconds, 10 times, 3 times a day
• Keep a healthy weight
• Stop smoking: coughing adds pressure
• Empty your bladder on a schedule

Pelvic floor physical therapy, a pessary device, or surgery can help when exercises aren't enough.

Prevention

To prevent it:

• Do pelvic floor exercises
• Keep a healthy weight

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to a urologist (urinary tract doctor).

Living with it

• Keep a simple diary of symptoms, triggers, and medicines to bring to visits.
• Bring a list of your medicines and questions to each visit.
• Stay active in ways that feel good to you.
• Get enough sleep and manage stress.
• Long-term illness can affect mood. Tell your doctor if you feel down or anxious.

Back to school, work, or sports

• Most people can keep working or going to school.
• Ask about changes that help, like extra breaks or a flexible schedule. Workers may be covered by the ADA. Students may get a 504 plan.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

For caregivers

• Go to visits when you can and take notes.
• Keep a list of medicines, allergies, and doctors in one place.
• Learn the warning signs that need fast care.
• Take breaks and ask for help. Caregivers need care too.

Outlook

Treatment helps most people.

Getting ready for your visit

Bring a list of your symptoms and medicines.

What to bring

• Bladder diary

Questions to ask

• Would physical therapy help?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Stress urinary leakage (stress incontinence)