Overview
Stress incontinence is an affliction that around one in three AFAB (assigned female at birth) people experience. And, while you might not be familiar with the term, you may be familiar with questioning why you pee when you sneeze.
Stress incontinence occurs when physical activity or movement causes you to leak urine involuntarily. This might be sneezing, coughing, or lifting something heavy, and it can be an upsetting and embarrassing condition. It is caused by a weakening of the muscles used to prevent urination, such as the pelvic floor muscles or urethral sphincter. However, it is not the same as having an overactive bladder, which results from overactivity of the muscles that control the bladder.
This article explores the topic of stress incontinence, its causes, and some treatments. This article also discusses how to stop peeing when you sneeze.
Symptoms of Stress Incontinence
If you suffer from stress incontinence, you may leak urine when there's pressure on your bladder, which can happen when you do one of the following:
- Cough
- Sneeze
- Laugh
- Bend down
- Lift heavy items
-
Engage in exercise or sex
With mild stress incontinence, there may be a few drops of urine. However, when it is moderate to severe, there might be as much as a tablespoon of leakage.
When to See Your Doctor
If the symptoms of stress incontinence cause disruption in your daily life or are simply bothering you, it may be a good idea to seek advice from your physician.
Causes of Stress Incontinence
There are many different causes from life events to illnesses. Here are some of the most common.
Life Events
Incontinence can absolutely be caused by events in your life, such as:
Childbirth
When your baby moves through your vagina, this causes stretching to your pelvic floor, which can persist for some time, resulting in stress incontinence.
Prostate Surgery
Prostate surgery can cause damage to the muscles and nerves that control urination, and it can often take some time for this to heal.
Illness
If you are sick or run down for a long time, this will often cause muscle deterioration, including your pelvic floor and urethral sphincter muscles.
Obesity
Carrying excess weight on your abdomen places added pressure on the muscles controlling the bladder, reducing their effectiveness at preventing leaks of urine.
Smoking
A smoker's cough can put a lot of pressure on the pelvic floor muscles, causing them to weaken. This increases the chance of developing stress incontinence.
High Impact Activities
Some intense exercises such as running, cross-fit, and weight lifting will continually place pressure on the abdominal areas, which can sometimes weaken the pelvic floor muscles.
How Doctors Diagnose Stress Incontinence
When you see your doctor about possible stress incontinence, there are some tests they can run to confirm the diagnosis. Here are some of the most common.
Testing Bladder Function
Most of the tests for stress incontinence involve testing bladder function by one or more of these methods:
Measure Post-Void Residual Urine
This test is done after you have emptied your bladder as you usually would. After applying a local anesthetic, your doctor will insert a catheter into your bladder via your urethra. Any remaining urine will drain out, allowing the doctor to measure how much is left.
Measure Bladder Pressure
One way to diagnose stress incontinence is to check how much pressure your bladder can exert. This is done by filling your bladder with warm liquid and then asking you to cough or bear down to check for leaks.
Bladder Imaging
To achieve imaging of your bladder, a die that shows up on X-rays is added to a warm liquid that is inserted into the bladder via a catheter. Images are taken while filling and as you urinate.
Cystoscopy
This involves inserting a scope in your bladder that provides images of any blockages or abnormalities.
Solutions for Stress Incontinence
Depending on how severe your stress incontinence is, there is a wide range of treatments available that can help you manage and improve the condition. These come under three categories: behavior therapy treatments that are non-invasive and involve physical therapy and exercise, physical aids that help you deal with the problem, and invasive procedures for more severe cases.
Behavior Therapy
Kegel Exercises
Kegel exercises can be an excellent way to rebuild pelvic floor muscle strength. A physical therapist can guide you through the proper techniques, and you can usually see improvements in four to six weeks.
Monitor Fluid Consumption
Your physician may advise you on when to drink fluids and how much. They may also ask you to avoid alcohol and caffeinated or carbonated drinks. Maintaining a schedule of your fluid intake may be sufficient in itself to reduce stress incontinence problems.
Lifestyle Changes
Losing excess weight will reduce pressure on your bladder and quitting smoking may reduce the coughing that is causing stress incontinence. If a particular activity such as lifting weights is causing too much pressure on your pelvic floor, you may want to cut back on that too.
Bladder Training
Your doctor might provide you with a schedule for voiding your bladder. Voiding more frequently can reduce the pressure on the weakened muscles that's resulting in stress incontinence.
Aids
Vaginal Pessary
A vaginal pessary is a device that supports your bladder to prevent leakage and is fitted by a medical professional. It will require regular refitting and cleaning and is most useful in cases of bladder prolapse.
Urethral Inserts
This is a tampon-like device inserted into the urethra to prevent leakage. It can be worn for up to eight hours per day and is most useful for people engaging in strenuous activities.
Incontinence Products
Other incontinence products are available, such as pads or specialized underwear that serve to catch any leakage. These are good in mild cases or where other interventions are not practical, such as in the very elderly.
Procedures
Sling Procedure
A sling is constructed under the urethra, made from your own tissue, donor tissue, or synthetic mesh.
Bulking Agents
The area around the upper urethra is bulked up by the injection of synthetic polysaccharides or gels, improving the sphincter's ability to close.
Retropubic Colposuspension
In this procedure, sutures are attached to the ligaments along the pubic bone. This lifts and supports tissues near the upper urethra and bladder neck.
Inflatable Artificial Sphincter
This procedure is only used for men. A cuff around the upper urethra functions as a sphincter would and is controlled manually by the patient via a manually operated pump in the scrotum.
The Bottom Line
If you pee when you sneeze and you're not sure why, you may have stress incontinence. This is a weakness of the muscles that control when you pee and can be caused by:
- Childbirth
- Illness
- Obesity
- Smoking
- High-impact activities
Doctors have a broad range of diagnostic tools to detect if you have stress incontinence and can help with:
- Behavior therapy such as kegel exercises, fluid consumption monitoring, lifestyle changes, and bladder training
- Aids such as vaginal pessaries, urethral inserts, and incontinence products
- Surgical procedures
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