Stress urinary incontinence is the most prevalent type of urinary incontinence and refers to involuntary urine loss upon efort, exertion, sneezing, and coughing. Urgency urinary incontinence is defned as the complaint of involuntary leakage associated with urgency, and if both stress and urgency are present at the same time, it is called mixed urinary incontinence.
Stress urinary incontinence appears to peak between 45 and 59 years of age. Stress urinary incontinence is more common in white women than in women of African-American or Asian-American descent. The etiology of Stress urinary incontinence includes parity, obesity, surgical hysterectomy or pelvic surgery, diabetes mellitus, and pulmonary diseases. Physical activity level is another important factor that correlates positively with the severity of SUI. Urethral hypermobility resulting from loss of bladder neck and urethral support, trauma, radiotherapy, previous pelvic or uro-gynecological surgery, neurological disease, or weakness of the urinary sphincter are mechanisms of occurrence.
A physical examination is required. It is necessary to evaluate the residual urine volume with ultrasound and to evaluate its severity objectively with questionnaires. In some cases, it is necessary to perform a pressure flow study known as a urodynamic test.
- Perform preoperative urodynamic tests in cases of stress urinary incontinence with associated storage symptoms,cases in which the type of incontinence is unclear, cases in which voiding dysfunction is suspected, and cases with associated pelvic organ prolapse or prior surgery for SUI.
- Perform urodynamic tests if the findings may change the choice of invasive treatment.
- Do not use urethral pressure profilometry or leak point pressure to grade severity of incontinence as they are primarily tests of urethral function.
Treatment
-Weight loss
-Urinary containment
- Pelvic floor muscle training.
- Electromagnetic stimulation
- Electroacupuncture
