Controlling the bladder involves a combination of sensory signals and muscle control. Problems with either one can lead to stress incontinence. Stress incontinence is diagnosed when there is an involuntary leaking of urine during physical activity, such as exercise, straining, lifting, laughing or coughing. Stress incontinence can occur due to obesity, multiple pregnancies, advancing age or structural problems. This condition is more common in women. If symptoms appear, it is important to talk with a health care provider.
Lifestyle Changes
Stress incontinence can be an embarrassing problem, which can cause a delay in getting medical help and may lead to avoiding social situations. However, a variety of treatment options are available, and lifestyle changes can help.
MayoClinic.com suggests scheduling fluid intake throughout the day and avoiding caffeinated and alcoholic beverages. This can be combined with a program of scheduling bathroom trips, losing weight and quitting smoking.
Kegel Exercises
Strengthening the bladder muscles by performing Kegel exercises may help patients gain control, according to Drugs.com. The goal is to strengthen the pelvic muscles that allow the bladder to expand when it is full as well as the muscles that hold in urine until voiding is possible.
Kegel exercises involve contracting and relaxing the same muscles used to stop urine flow, gas or bowel movements. They should only be done when the bladder is empty. A doctor or physical therapist can explain these exercises and make suggestions as to how often they should be done.
Biofeedback equipment can be used to help a patient learn to contract the correct muscles. Improvements in bladder control may be seen in six to eight weeks. It may take months if the bladder muscles are very weak.
Pessary
In some cases, a vaginal insert, or pessary, may be inserted to help control leaking. A pessary is a ring-shaped device, similar to a contraceptive diaphragm, that is placed in the vagina. The goal is to place pressure against the walls of the vagina and urethra to help stop involuntary leakage of urine.
Pessaries are available in a variety of types and sizes, and a physician can make recommendations on the right one. It can be taken out every night and during intercourse or kept in for up to a week at a time before it needs to be cleaned. If placed correctly, it should not be visible or cause irritation or bleeding.
Injections
Some patients may benefit from injections of substances such as collagen and carbon spheres into the tissues near the bladder. According to the National Kidney and Urologic Diseases Information Clearinghouse, these agents can thicken the tissues in this area and narrow the opening to the bladder in order to help reduce the chance of leaking. The body may eventually naturally eliminate these substances, so injection treatments may need to be repeated if symptoms return.
Surgery
Some cases of stress incontinence result when the bladder moves out of place. This can happen during childbirth or injury. In these cases, surgery may be necessary to reposition the bladder. Various surgical procedures can be performed, and a surgeon will go over options, based on individual needs.
