From the sound of its name, you might think this type of incontinence is brought on by mental stress, but that’s more a consequence of it. Stress incontinence refers to physical stress put on the bladder by internal forces.
In stress incontinence, the sphincter muscle that you squeeze to avoid a leak and your pelvic muscles, which support the bladder and urethra, are weakened and the sphincter in particular doesn’t work as needed when everyday actions like coughing, laughing or lifting a heavy object increase pressure from the abdomen.
Non-surgical treatments that may help start off with behavior or lifestyle changes—cutting out alcohol and coffee because they can stimulate the bladder and cigarettes because they worsen coughing (among all their other risks). Some foods can actually irritate your bladder, like soda, citrus fruits and spicy dishes; keeping a food diary can show you if your bladder reacts when you eat any of these items.
Some women have success curbing stress incontinence by changing their bathroom habits—eat whole grains and other high fiber foods to avoid constipation (which can add more pressure to the bladder) and go to the bathroom at more frequent intervals to encourage your bladder to empty. Losing weight and switching to exercises that don’t cause the bouncing of jogging for example may help.
"Internal” exercises that involve contracting and holding the pelvic muscles and medication are other options that you should talk to your doctor about.
If you've tried non-invasive approaches to stopping stress incontinence without success or without enough success, or if the incontinence has gotten worse, there are surgical options to consider, including some that are relatively simple. For women, many involve your doctor placing a sling around a strategic area of your bladder for adding support. Depending on where and how the sling is placed, it may be made of a synthetic mesh or your own tissue. The idea behind the sling is to create a platform under part of the urethra to help you stay continent even when you experience increases in abdominal pressure. For some procedures, a small vaginal incision or a vaginal and an abdominal incision may be all that's needed.
These minimally invasive sling procedures are the primary surgical approach for treating uncomplicated stress incontinence. They work well and involve only a short operation and a quick recovery time for you. New techniques and materials have improved results over the years, with few complications.
There are also sling procedures for men who develop stress incontinence following prostate cancer surgery. Talk to your urologist to see if you're a good candidate. If you've had the procedure, share your opinions in our online community.