What Causes Stress Urinary Incontinence?

Stress Urinary Incontinence (SUI) is a very common type of incontinence and causes the involuntary leakage of urine due to pressure placed on the bladder. Pressure can result from everyday physical activity like walking, running, laughing, coughing, sneezing, or lifting heavy objects. These physical activities often begin to have this effect on the bladder due to changes in the musculature of the pelvic floor, which are commonly the result of pregnancy and childbirth, menopause, obesity, hysterectomy, pelvic organ prolapse, or intrinsic sphincter deficiency (ISD). Below, we explain several common issues associated with stress urinary incontinence as well as the treatments we offer for them here at Austin Urogynecology.

 
Uterine Prolapse

Uterine prolapse is a common form of pelvic organ prolapse that becomes more prevalent with age. As the pelvic floor muscles that support the uterus weaken, it can begin to bulge into the vagina. Uterine prolapse can be categorized in four different stages, ranging from benign to severe. Symptoms include pelvic pain or pressure, pain during intercourse, difficulty defecating, and urinary issues such as incontinence. It is not uncommon for other organs to move out of place as a result of the same pelvic floor weaknesses that cause uterine prolapse, so it can also co-occur alongside cystocele (bladder prolapse) and rectocele (rectal prolapse).

Treatment options for uterine prolapse are a pessary or surgical repair (such as hysterectomy and/or da Vinci sacrocolpopexy). In many cases, we use a mid-urethral sling in tandem with pelvic organ prolapse surgeries as stress urinary incontinence cannot usually be addressed with prolapse surgery alone.

 
Intrinsic Sphincter Deficiency

Intrinsic Sphincter Deficiency (ISD) is a condition that occurs when there is muscular weakness of the urethral sphincter, and often leads to stress urinary incontinence. Intrinsic sphincter deficiency can be the result of genetics, nerve damage from surgery, or even some neurological disorders. While stress urinary incontinence and urinary leakage can occur without the presence of intrinsic sphincter deficiency, cases are more frequent and severe in patients suffering from ISD.

The mid-urethral sling is the mainstay of treatment for ISD, and entails the placement of a synthetic mesh underneath the urethra. The mesh sling provides support to the urethra so that abdominal pressure from activity does not squeeze the bladder.

If you would like to learn more about stress urinary incontinence, pelvic organ prolapse, or intrinsic sphincter deficiency, don’t hesitate to schedule a free consultation by contacting Austin Urogynecology today.