How is stress incontinence treated?

Stress incontinence, characterised by the unintentional leakage of urine, is a common problem that can affect wellbeing, leading to embarrassment, social isolation and limited physical activity. While people of all ages can be affected, stress incontinence is more prevalent among women over 65.

Here, Mr Rufus Cartwright, renowned consultant gynaecologist based in London, provides an expert insight into stress incontinence, including causes and treatment.

What is stress incontinence?

Stress incontinence is a common condition characterised by the involuntary leakage of urine during moments of physical activity, such as when coughing, sneezing or exercising. The condition affects an estimated three million women in the UK alone.

What are the causes?

The main cause of stress incontinence is weakened or damaged pelvic muscles, which can be the result of pregnancy, childbirth, menopause, obesity or ageing. These weakened pelvic muscles allow urine to leak when the bladder is put under pressure, such as during physical activity.

How is stress incontinence treated?

Non-surgical treatments for stress incontinence, such as pelvic floor exercises, lifestyle changes or medication, may be effective for some patients.

However, for patients who do not see improvement with non-surgical treatments, surgery may be the best option. This may include:

• An autologous fascial sling procedure: During an autologous fascial sling procedure, the surgeon places a sling of tendon underneath the urethra to support it, reducing the pressure on the bladder. This helps to prevent urine leakage. The sling, which is typically harvested (removed) from a caesarean incision, can be placed in the vagina through a very small incision.
• A laparoscopic Burch colposuspension procedure: During a laparoscopic Burch colposuspension procedure, the surgeon sews the bladder neck and the urethra to the pubic bone so that the bladder neck is supported. This helps to prevent urine leakage. The procedure can also be performed using open surgery (which involves a single, large incision), however, keyhole surgery (which involves one or more small incisions) provides an easier recovery.
• Bulking agents: A urethral bulking agent is a substance, similar to a filler, that is injected into the tissues around the urethra to increase its thickness and enhance the closure of the bladder. A bulking agent injection is a minimally invasive procedure that can be performed in an outpatient setting.

Before making a decision, patients should discuss and carefully consider the benefits and risks of each treatment or procedure with their urogynaecologist. The choice of treatment will depend on the patient’s individual needs and medical history.

Living with stress incontinence

Stress incontinence can be a challenging condition to live with, but there are treatments available that can help to treat it effectively. Patients should not be afraid to discuss their options with their urogynaecologist and seek a suitable treatment that will help to improve their quality of life.

Mr Rufus Cartwright is a leading consultant gynaecologist with over 20 years of experience.

If you require expert assistance for stress incontinence, do not hesitate to book an appointment with Mr Cartwright via his Top Doctors profile today.