Get answers to your Urinary Incontinence / Urogynecology questions.
The primary symptom of stress incontinence is leakage due to activities that apply pressure to a full bladder. High-impact exercise poses the greatest risk for leaking. But stress incontinence can occur with even minor activities, such as:
Leakage stops when the stress ends. If the leakage persists, it is more likely to be urge incontinence.
Stress incontinence occurs because the internal sphincter does not close completely. In both men and women, the aging process causes a general weakening of the sphincter muscles and a decrease in bladder capacity. Causes of stress incontinence, however, may differ between men and women.
In women, stress incontinence is nearly always due to one or both of the following:
Many women are prone to one or both of these problems, which can occur under the following circumstances:
Urethral Hypermobility. In urethral hypermobility the urethra does not close properly, allowing it to move too much (hypermobile). This condition typically occurs when the pelvic floor muscles in women become weak, and the following events occur:
Stress incontinence associated with urethral hypermobility is sometimes categorized as type 1 or type 2.
Intrinsic sphincteric deficiency (ISD). Intrinsic sphincter deficiency (sometimes called type 3) is the other major cause of stress incontinence in women. It occurs when the bladder neck muscles are damaged or weakened. The result is twofold:
This is the most severe stress incontinence in women and usually occurs after previous surgeries for incontinence.
Prostate treatments can impair the sphincter muscles. Such treatments are the major causes of stress incontinence in men. They include the following:
Surgery or radiation for prostate cancer. Some degree of incontinence occurs in nearly all male patients for the first 3 - 6 months after radical prostatectomy. Within a year after the procedure, most men regain continence, although some leakage may still occur.
Surgery for benign prostatic hyperplasia. Stress incontinence occurs in 1 - 5% of men after transurethral resection of the prostate (TURP), the standard treatment for severe benign prostatic hyperplasia.
Incontinence after prostate procedures is often a combination of urge and stress. Because studies often combine the two types of incontinence, it is not always clear which predominates.
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