Stress Urinary Incontinence

Stress urinary incontinence (SUI) is the involuntary loss or leakage of urine that occurs during physical activity such as exercise, laughing, coughing and sneezing. The “stress” is added pressure on your bladder. Individuals who have SUI have weak pelvic muscles that can allow urine to leak when a cough, sneeze or other action puts pressure on the bladder.



While stress urinary incontinence is more common as people age, it is not caused simply by aging. A number of factors influence SUI including:

  • Pregnancy and childbirth, which can stretch, weaken or even damage pelvic floor muscles in women
  • Neurological conditions that cause damage to the nerves including multiple sclerosis, spina bifida and spinal cord injuries
  • Obesity
  • Chronic cough, oftentimes caused by smoking
  • Certain medications, excessive alcohol consumption and caffeine
  • Menopause, due to decreased hormones
  • Pelvic surgery or radiation treatment 


Common symptoms of SUI include:
  • Urine leaks when you cough, laugh, sneeze, exercise, lift heavy objects, etc.
  • Urine leakage worsens when your bladder is full.



As a first step to diagnosing your bladder control problem, your physician will perform a comprehensive medical history and evaluation to accurately diagnose the condition in order to prescribe the best treatment option for you.  Your doctor may also order additional tests including:

  • Urinalysis
  • Blood work
  • A bladder diary – your physician may ask you to keep a record of what you drink, your urine output, when leakage occurs and what you were doing (coughing, laughing, exercising, etc.) when urine leakage occurred.

Specialized tests may also be performed to get a clear idea of the cause of your SUI including:

  • Pelvic ultrasound – This test painlessly checks for abnormalities in the bladder, urinary tract or genitals.

  • Stress test – Looks for leaking urine when you cough, laugh or put other types of pressure on your bladder.

  • Postvoid residual test (PVR) – Determines how well you empty your bladder by measuring residual urine after voiding using a thin tube (catheter) passed through your urethra into the bladder. By measuring residual urine, your doctor can determine if there may be a blockage or nerve or muscle problem.

  • Cystoscopy – A tiny instrument called a cytoscope is inserted into the urethra to find and/or remove abnormalities. This procedure can be performed in your doctor’s ambulatory surgical center.

  • Cystogram – A special X-ray of your bladder taken while filling and evacuating.

  • Urodynamic tests – Diagnostic tests that evaluate the function of the bladder and urethra and include Uroflow, cystometrogram, EMG, pressure flow study, or videourodynamics.

Learn more about treatment of SUI in women. 

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