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Stress Urinary Incontinence (SUI)

  • According to the Agency for Healthcare Policy Research, 13 million Americans are incontinent and 85% (11 million) are women.

    • Based on the results of a Gallup survey conducted in April 2002, 70% of incontinent women have symptoms indicating that they have some form of stress urinary incontinence (SUI).
    • SUI is the most prevalent type of incontinence.

  • SUI is the involuntary sudden loss of urine that often happens with laughing, sneezing, coughing or exercise.

    • Stress urinary incontinence (SUI) occurs when abdominal pressure or "stress" is placed on a weakened urethral sphincter muscle (the bladder "valve" outlet).
    • SUI often goes undiagnosed because many women are too embarrassed to discuss it with their doctors. Estimates show only one out of 12 women talk to their doctor.
    • Low awareness of the condition among the medical community and the absence of a drug treatment make SUI a low priority for physicians.
    • SUI often begins affecting women in the prime of their lives.
    • Many women with incontinence wear sanitary napkins or wads of tissues in their panties to conceal urinary leaks.
    • SUI can diminish women's ability to cope with daily activities (domestic chores, exercise, etc.), and can have a negative effect on their social life, as they feel obliged to wear unattractive clothes and restrict their activity for fear of the odor.
    • Emotionally, women can experience a general lack of self-confidence and shame.
    • Many assume that SUI is a normal symptom of aging. Thus, persons with this condition do not go for treatment and they may withdraw from social life, reluctant to discuss their condition with their physician, family, or friends.
    • Most cases of SUI can be managed using a combination of the currently available treatments:  surgery, pharmacologic interventions, behavioral methods, devices, and alternative measures.

  • What causes SUI?

    • Pelvic muscle strain
    • Childbirth
    • Pelvic muscle tone loss
    • Estrogen loss/menopause
    • Obesity

  • SUI affects women of all ages including young mothers, pre-menopausal women and seniors.  The average age of onset is 48.

  • SUI can be an embarrassing, unpredictable condition; It can cause women to:

    • Avoid an active lifestyle
    • Shy away from social situations
    • Constantly search for the nearest bathroom
    • Carry around a change of clothing and underwear
    • Wear dark pants and skirts
    • Tie shirts around their waist or wear long shirts
    • Become too embarrassed to talk to their doctor

  • According to Gallup survey conducted in April 2002:

    • 70% of women with SUI surveyed said they worry about coughing, sneezing and even laughing in public for fear of having an accident
    • 35% report changing their activities to accommodate the condition including avoiding exercise, traveling less frequently and avoiding sex   
    • 62% waited a year or longer before even discussing their condition with a doctor.

  • SUI is treatable!  Options include:

    • Self management: Kegel or pelvic muscle exercises (may be useful depending on the severity of your condition), biofeedback, pessaries
    • Dietary changes:  avoid caffeine, nicotine and spicy foods
    • Medication: drugs for overactive bladder, hormone therapy
    • Surgery/Minimally invasive procedures

  • Surgery may be warranted when conservative therapy has failed.

  • There are many surgical options to treat incontinence; the type of operation depends on cause.  The goal is to restore urethra and bladder to normal positions in pelvis.

    • Common SUI surgical procedures include:
    • Bladder neck suspensions
    • Needle suspensions
    • Conventional sling procedures

  • New minimally-invasive procedures such as GYNECARE TVT Tension-free Support for Incontinence™ restore the body's ability to control urine loss.

    • During the procedure the surgeon provides support to the urethra by placing a "sling" or mesh tape beneath it.  The tape supports the urethra during sudden movements, such as a cough or sneeze, keeping the urethra closed and preventing the involuntary loss of urine.
    • The procedure is completed in 30 minutes, patients may be able to return home the same day, there is a reduced need for post-surgical catheterization, short recovery time and patients experience minimal pain.
    • Evidence of success of the procedure is seen the same day.
    • Older or overweight women as well as women who have undergone other surgical treatments may still be candidates for minimally-invasive procedures. 
    • Pregnant women, women who plan on becoming pregnant and women on anticoagulation therapy are not candidates.

  • All medical procedures contain some riskPotential risks include hemorrhage/hematoma, injury to blood vessels, bladder or bowel, difficulty with urination.

Click here for more information on incontinence.

Created: 7/11/2002  -  Donnica Moore, M.D.
Reviewed: 6/9/2003  -  Donnica Moore, M.D.

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