Stress Urinary Incontinence

Excerpt

Urinary incontinence, defined by the International Continence Association as any involuntary leakage of urine, significantly affects patients' quality of life worldwide and poses a substantial global economic burden. In women, this condition exceeds 60% during their lifetime, with a higher incidence among those who have had children and increasing with age. Types of urinary incontinence include stress, urge, overflow, and mixed incontinence, each with distinct and sometimes overlapping causes. Please see StatPearls' companion resource, "Urinary Incontinence," for more information.

Stress urinary incontinence is characterized by the sudden involuntary leakage of urine during activities that increase intra-abdominal pressure, such as exertion, sneezing, coughing, laughing, or straining. This condition arises from a combination of anatomical and physiological factors that disrupt the normal urinary continence control mechanisms. Nonmodifiable risk factors include female sex and White race, whereas modifiable factors include smoking, obesity, and chronic constipation

A survey conducted between 2005 and 2016 involving over 15,000 participants in the United States found that more than half had experienced some form of incontinence, with approximately 25% reporting stress-only urinary incontinence. Although not life-threatening, urinary incontinence profoundly impacts the aging population, necessitating surgical intervention when conservative treatments fail. Stress incontinence imposes substantial financial burdens, with management costs in the United States exceeding $13 billion annually in recent years.

Treatment options include conservative and behavioral measures, lifestyle changes, bladder training, Kegel exercises, physical therapy, biofeedback, electrostimulation, pharmacotherapy, pessaries, urethral bulking agents, slings, and various other surgical procedures, including artificial sphincters.

This review summarizes the diagnosis and all the various treatment options available for patients with stress urinary incontinence.

Lugo T, Leslie SW, Mikes BA, Riggs J. Stress Urinary Incontinence. 2024 Aug 31. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 30969591.