Stress Urinary Incontinence – Causes of SUI
There are various factors that cause SUI like pregnancy, childbirth, obesity, menopause, hysterectomy, medication side effects etc.
Pregnancy: During pregnancy the hormone relaxin softens the muscles of the pelvic floor and the weight of the baby adds greater stress to the pelvic floor. Around half of the women suffer from SUI during pregnancy.
Childbirth: Women who undergo vaginal delivery are at an increased risk of SUI because the muscles around your pelvic floor become stretched and bruised due to child birth.
Obesity: The greater the abdominal pressure on the bladder area, the greater the risk of urinary stress incontinence. Thus, patients with very high body mass index (BMI) who suffer from morbid obesity (BMI 40+) or malignant obesity (BMI 50+) are at greatest risk of SUI.
Menopause: After the menopause the estrogen levels are lower, which can mean muscle pressure around the urethra is weaker and leaks are more likely. Since the urethra becomes less elastic it does not close completely. Postmenopausal women are also more likely to be overweight and have had a hysterectomy – additional factors for SUI.
Hysterectomy: hysterectomies can damage the pelvic floor resulting in SUI.
Medication side effects: Some medication such as alpha blockers used to treat high blood pressure, certain antidepressants and sedatives and some muscle-relaxant drugs can affect the pelvic floor resulting in SUI.
Treatment options for SUI
Stress urinary incontinence can be treated by non-drug methods such as:
- Lifestyle changes to reduce pressure on your bladder e.g., losing weight, not smoking and drinking less amounts of liquid.
- Pelvic floor exercises such as Kegel exercises. Other treatment options include medication or surgery, such as; Anti-depression medication such as deloxetine or imipramine.
- Pessaries (removable medical device that is inserted into the vagina).
- Bladder neck suspension such as MMK (marshal-Marchetti-Krantz)and Burch colposuspension.
- Bulking agents like hydrogel injected around the urethra (periurethral bulking injections).
Tension-free vaginal tape (TVT)
If you need surgery, it is important to find a surgeon who is experienced in the types of surgical procedures used to treat incontinence.