Stress incontinence is an accidental leak when you cough, laugh or sneeze. It is the most common form of urinary incontinence in women.

Stress incontinence occurs when the sphincter, which acts like a valve to the bladder, opens as a result of exertion. This causes a small amount of urine to leak out. This happens as a result of a weakness in the sphincter and pelvic floor muscles.

It is quite different from overactive bladder, which is caused when the detrusor muscle in the bladder wall contracts before it should. This creates a sudden and powerful urge to urinate.

In stress incontinence the leakage is caused by a strong movement like:

• Coughing, laughing or sneezing
• Exercising, particularly jumping
• Lifting
• In severe cases, walking, getting out of bed, or standing up

It can worsen during the week before a period because of the effect of certain hormones in the body on the muscles of the pelvic floor.

Stress incontinence is very common, particularly in women between 35-60.
Many common life effects can weaken the pelvic floor and lead to stress incontinence:

• Pregnancy
• Childbirth, particularly when there is a tear or episiotomy
• Being overweight
• Damage to the pelvic floor from a hysterectomy
• Smoking which causes a chronic cough
• Lower oestrogen levels after the menopause
• Occasionally certain medications can weaken the pelvic floor

Damage to the pelvic muscle can occur as a result of fracture, bladder neck surgery or prostatectomy in men.

Lifestyle changes and pelvic floor exercises can be very effective in dealing with stress incontinence. Sometimes, surgery is necessary to rectify the problem.

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