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Stress Incontinence Synopsis

Stress continence is defined as being an involuntary loss of urine that occurs during physical activity, coughing, sneezing, or laughing. Stress incontinence is basically a bladder storage problem where the strength of the urethral sphincter has greatly diminished, and the sphincter doesn’t have the ability to prevent the urine flow when there is an increased pressure from the abdomen.

Stress incontinence may result from weakened pelvic muscles that support the bladder and urethra or because of the malfunction of the urethral sphincter. There are other things that could result in a weakened urethra including prior trauma to the urethral area, neurological injury, as well as some medications.

Sphincter weakness can occur in women after they have had pelvic surgery or men after prostate surgery. Stress incontinence is common in women who have had multiple pregnancies and vaginal childbirths, or those who have pelvic pro lapse which is the protrusion of the bladder, urethra, or rectal wall into the vaginal area, with cystocele, cystourethrocele, or rectocele.

Stress urinary incontinence is one of the most common types of urinary incontinence in women. There are many risk factors for stress incontinence such as having sex, aging, childbirth, smoking, and obesity. The risk of stress incontinence is increased if you have a condition that causes chronic coughing such as chronic bronchitis and asthma.

Occasional urinary incontinence is quite common in women. In fact studies have shown that nearly half of all women have occasional urinary incontinence and one in ten women experience frequent incontinence. It becomes more common as you age. Almost twenty percent of women over the age of seventy-five have daily urinary incontinence.

A person must have the psychological and physical ability to recognize and respond to the urge to urinate. The ability to hold urine is dependant upon normal function of the lower urinary tract, kidneys, and nervous system. The urination process involves two phases starting with the filling and storage phase which is followed by the emptying phase. During the first phase urine fills the bladder with liquid from your kidneys.

Your bladder stretches to accommodate for the increasing amounts of urine. It is estimated that the first sensation to urinate occurs when you have about 200 ml of urine in your bladder. A normal functioning nervous system will respond to the stretching sensation by alerting you that you need to urinate while allowing your bladder to continue to fill.

An average person has the ability to hold about 350 to 550 ml of urine. To be able to fill and store urine properly you are required to have a functional sphincter muscle, control of the output of urine from the bladder, as well as a stable bladder wall muscle also known as the detrusor muscle. The emptying process requires the ability of the detrusor muscle to correctly contract force urine out of the bladder, as well as the ability to be able to relax the sphincter to allow the urine to exit the body.

Sven Ullmann
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