Stress Incontinence

From Incontinence to In-Control

Do you leak with laugh, cough, sneeze, or exercise? Urine leakage with these activities is known as stress urinary incontinence. Approximately 18 million women in the U.S. have incontinence. Break free from urine leakage that occurs with activity and take control of your pelvic floor.

Urinary incontinence is a medical condition that has significant negative effects on quality of life and may cause social stigma, financial hardship, and associated medical problems. Affected individuals often delay seeking treatment due to shame and embarrassment.

Stress incontinence is urine leakage caused by physical activity that places “stress” on the bladder and sphincter muscle. Physical changes resulting from smoking, pregnancy, childbirth, weight gain, chronic constipation, chronic coughing, and menopause often cause stress incontinence.

Stress incontinence occurs during periods of increased intra-abdominal pressure. Typically, patients report involuntary urine loss during coughing, laughing, and sneezing. Incontinence worsens during high-impact sports activities such as golf, tennis, or aerobics. These types of physical activity cause the abdominal muscles to suddenly place pressure on the bladder or cause too much movement of the urethra within the body.

In all cases, the sphincter muscle (which prevents urine being expelled from the bladder) needs to be healthy and strong to handle the increased pressure placed upon it. The problem may also be exacerbated if there is a weakness or defect of the sphincter muscle known as intrinsic sphincter deficiency. Stress incontinence is common in women and, in most cases, can be treated. Often times stress incontinence is accompanied by other types of incontinence, so it is important to determine what types exist.

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Patients Suffering from Stress Incontinenece May Experience

  • Leakage of urine when coughing, sneezing, or laughing
  • Frequent trips to the bathroom in order to avoid accidents
  • Reluctance to exercise to avoid accidents
  • Leakage upon rising from a chair
  • Sleeping through the night but leaking when getting out of bed in the morning

Patients with urinary incontinence should undergo a basic evaluation that includes a history, physical examination, and urinalysis. Also crucial is a combination of a patient’s voiding diary, cotton-swab test, cough stress test, measurement of postvoid residual (PVR) urine volume, urodynamic studies and Additional information from cystoscopy may be needed in selected patients.

Nonsurgical Treatments for Stress Incontinence


FemiLift is a state-of-the-art, pain-free, minimally invasive, in office laser procedure designed to treat stress urinary incontinence. It is the only FDA approved technology for vaginal rejuvenation. The FemiLift does not require surgery, anesthesia, or any downtime. The FemiLift treatment is a treatment performed in the office in less than 15 minutes. The treatment involves painless laser light emitted into the vaginal tissue wall which allows for collagen and blood vessel development to improve surrounding tissue. This development of healthier tissue allows for reconstruction of the tissue improving bladder control significantly reducing stress urinary incontinence. This treatment is appropriate for women of all ages and allows a safe, quick, and effective treatment of stress urinary incontinence.

Pelvic Muscle Exercises (PME)

Also known as Kegel exercises, PME techniques are an option for stress incontinence. Most women require guidance from a medical professional to learn how to contract the pelvic floor muscles correctly.


A specialized therapist places an electrode over the pelvic floor muscle and this “reads” the activity in your muscle. A wire connects the electrode to a TV monitor and you may watch yourself contracting the muscles on the screen. You learn how much to squeeze, when to let go, and how many exercises to do, and you can see yourself improve in a few weeks. A conservative, nonsurgical approach to treatment but must be maintained for life.

Pelvic Floor Electrical Stimulation (PFES)

Vaginal probes that deliver a tiny electrical current to the pelvic floor may be useful in the treatment of stress and mixed incontinence.

PFES devices take the guesswork out of pelvic muscle toning. They gently stimulate the pelvic floor muscle to strengthen and tighten with minimal effort with incredible results. It’s designed for home use while reading a book or watching TV and is discreet. A much more efficient and effective way of building pelvic muscle tone and not only improve the symptoms of incontinence but increases sexual satisfaction.

Other Benefits:

  • Increase in overall bladder control
  • Decrease in accidents and leaks
  • Reluctance to exercise to avoid accidents
  • Increase in blood flow leading to increased sensitivity
  • Increased perineal healing after vaginal birth

It is covered by Medicare and other health plans and only available by prescription. See us for a consultation today. No mom should be without one.

Pessary Devices for Stress Incontinence

One of the reasons for stress incontinence may be weak pelvic muscles, the muscles that hold the bladder in place and hold urine inside. A pessary is a stiff ring that is inserted into the vagina, where it restores pelvic anatomy and supports the wall of the vagina and the nearby urethra. The pressure helps reposition the urethra, leading to less stress leakage.

Surgical Treatments for Stress Incontinence

With recent advances in medical technology and better understanding of female anatomy and physiology, today’s surgical options are available for correcting stress incontinence with excellent success.


A sling procedure is done to create support where the urethra connects to the bladder (a.k.a. bladder neck). A sling is especially effective for the woman who has the diagnosis of Intrinsic Sphincter Deficiency (ISD) where the sphincter muscle is ineffective at holding urine in the bladder during certain “stressful” activities such as coughing, sneezing or exercising.

The slings differ in the type of material, sutures, and points of anchoring. The sling is placed under the bladder neck and is secured to a point of attachment (bone, abdominal wall, and ligament) through a vaginal incision. Therefore, when the woman coughs or sneezes, the bladder does not have as much motion now that the “hammock” is in place and so she will not experience much leakage.

This treatment is done in a procedure room under anesthesia and/or local and the patient goes home the same day. The most recent efficacy statistics for patients undergoing sling procedures is upwards of approximately 85% for patients who have had the surgery as long as 10 years ago. A sling procedure is considered “curative” for the female patient.

Anterior Repair

Historically anterior repair (colporrhaphy) has been used to treat stress incontinence in conjunction with a bladder and urethra drop (cystocele) for years. Although anterior repair operation was commonly used for both incontinence and anterior vaginal wall relaxation, currently anterior repair is only done in conjunction with the sling if prolapse exists and not the operation of choice for most patients with just stress incontinence.

Anterior repair only has a cure rate of 20-30% for stress urinary incontinence. Understanding Women GYN does not recommend anterior repair operation, as her procedure of choice, for stress urinary incontinence. She will choose the most appropriate treatment based upon the individual patient’s needs and urodynamic testing results.

Other Helpful Tips

Many women manage urinary incontinence with menstrual pads that catch slight leakage during activities such as exercising. Also, many people find they can reduce incontinence by restricting certain liquids, such as coffee, tea, and alcohol. Finally, many women are afraid to mention their problem. They may have urinary incontinence that can improve with treatment but remain silent sufferers and resort to wearing absorbent undergarments, or diapers. This practice is unfortunate, because diapering can lead to diminished self-esteem, as well as skin irritation, odor issues and sores.

  • Don’t Hide
  • Begin looking for ways to improve or eliminate your condition.
  • Avoid Smoking
  • Modify consumption of bladder irritants. Track your food and beverage intake to determine what may be contributing to the problem
  • Maintain weight or lose weight if necessary. Even 15 pounds help tremendously. Understanding Women GYN has a unique successful weight loss program that can assist you.
  • Eat more fiber
  • Participate in regular exercise
  • Temporarily eliminate activities that may be contributing to incontinence. Once your pelvic muscles are stronger you can add back activities.
  • Exercise your pelvic floor muscles every day by using a Pelvic Muscle Trainer. Every mom can profit from it.
  • Visit Understanding Women GYN

For further information regarding any procedure, or to confidentially speak to one of our qualified personnel, please contact us at 602.393.0661.

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Types of Urinary Incontinence

Click on the various types of urinary incontinence below and learn more about our specialized treatment options.

Stress Urinary