Urinary Stress Incontinence

Question 1

What is this describing?

Answer 1

Involuntary leakage of urine on effort or exertion, or on sneezing or coughing.

Question 2

What are the causes of stress inontinence?

Answer 2

1. Pregnancy, vaginal delivery, instrumental delivery, tears.
2. Obesity, increasing age
3. Previous hysterectomy

Question 3

How is stress incontinence investigated?

Answer 3

1. Abdominal exam, speculum, bimanual examination
2. Urine dipstick to exclude UTI
3. Urodynamic cytometry to exclude overactive bladder if surgery is considered.

Question 4

How is stress incontinence managed?

Answer 4

1. Lose weight, optimise diabetes, bladder diary
2. Address causes of chronic cough/constipation
3. Reduce excessive fluid intake
4. Pelvic floor muscle training for 3 months
5. Surgery if other methods have failed - mid urethral sling