Stress Urinary Incontinence

Stress urinary incontinence occurs when your bladder leaks urine during physical activity or exertion. It may happen when you cough, sneeze, lift something heavy, change positions, or exercise.

Causes

Stress incontinence occurs when the tissue that supports your urethra gets weak.

• The bladder and urethra are supported by the pelvic floor muscles. Urine flows from your bladder through your urethra to the outside.
• The sphincter is a muscle around the opening of the bladder. It squeezes to prevent urine from leaking through the urethra.

When either set of muscles become weak, urine can pass when pressure is placed on your bladder. You may notice it when you:

• Cough
• Sneeze
• Laugh
• Exercise
• Lift heavy objects
• Have sex

Weakened muscles may be caused by:

• Childbirth
• Injury to the urethra area
• Some medicines
• Surgery in the pelvic area or the prostate (in men)
• Being overweight
• Unknown causes

Stress incontinence is common in women. Some things increase your risk, such as:

• Pregnancy and vaginal delivery.
• Pelvic prolapse. This is when your bladder, urethra, or rectum slide into the vagina. Delivering a baby can cause nerve or tissue damage in the pelvic area. This can lead to pelvic prolapse months or years after delivery

Treatment

• BEHAVIOURAL CHANGES – Changes in diet / fluid intake/ weight reduction
• Kegel exercises
• Vaginal Sling surgery (TOT Tape Insertion)

What is a trans obturator tape (TOT) procedure?

This is the procedure for urinary stress incontinence and it is performed under a general or spinal anaesthetic.

A small incision is made on the wall of the vagina and the permanent tape is introduced via the vagina to sit under the urethra. The needles used to place the tape are introduced through small incisions at both sides of your upper inner thigh (see picture). The tape used is a permanent mesh, which will not be dissolved in your body.

Surgery for stress incontinence aims to give you more control over your bladder. It cannot always cure the problem completely.