Other Names:
Urinary Stress Incontinence

Symptoms:
Occasional dribbling. An involuntary loss of urine, in very small amounts, accompanies coughing, sneezing, laughing, walking, running, lifting, or any sudden shock or strain.

Cause:
Incontinence tends to occur in women more than men, although older men may also have it.

A wide variety of causes can be involved—including food allergies, hypoglycemia, multiple dystrophy, multiple sclerosis, cancer, stroke, injuries, and surgical damage.

Other causes include repeated births, poor pelvic floor tone, damage to pelvic floor by the physician at time of delivery, failure to do prenatal and postnatal exercises, visceroptosis, overweight, and poor abdominal tone.

It may follow a prolonged labor during childbirth, resulting from the stretching of the pelvic floor. If postpartum exercises are not done, this problem, which may disappear for years, may later return.

Incontinence is far less likely in the nullipara (women who have never delivered a child).

Treatment:
• The best pelvic floor exercises are variations of the Kegel exercise, and should begin early in pregnancy or before, and continue on to at least 3 months after childbirth. These exercises strengthen certain muscles.

• Slow urine flow and eventually stop it. Doing this helps you recognize the muscles involved. Later, practice stopping urine flow, hold for 1-2 seconds, and repeat 6-8 times as you urinate. You should eventually be able to stop urine flow completely with no leakage. Learn to slowly relax pelvic floor muscles in stages from full contraction to full relaxation.

• Practice tightening these muscles at various other times during the day. Repeat 6-8 times each session and 50-100 times a day. Hold each contraction for 2-5 seconds, then relax.

• When doing these exercises, do not hold your breath. Bear down; that is, push down on the pelvic floor or contract the buttocks, inner thighs, or abdominal muscles. When beginning, do not exhaust the pelvic muscles. Whenever contractions weaken, discontinue at that time. Build muscle strength slowly; there is no rush.

• Avoid alcohol, caffeine, tobacco, and grapefruit juice.

• Use cranberry juice instead.

• Reduce general fluid intake, but not too much.

• Avoid constipation.

• Lose weight.

• Go when you have to; do not wait, or you weaken bladder control.

• Double voiding is helpful: After voiding, stand up and sit down again. Lean forward slightly at the knees and try again.