Urinary incontinence is any unintentional leakage
of urine. It can be caused by several underlying medical conditions, including
urinary infections, strokes, pregnancy, obesity, neurological problems, and
other health problems sometimes associated with aging. Stress incontinence is a type of urinary incontinence. A person with
stress incontinence is unable to hold urine while coughing, sneezing, or laughing
or during other movements that put pressure on the bladder, the organ that collects and holds urine. Fortunately, stress incontinence
can usually be successfully treated.
The July 16, 2003, issue of JAMA includes an article about
When you urinate, the muscles of the bladder tighten and squeeze the
urine out through the urethra, a tube that leads
from the bladder to the outside of your body. At the same time, muscles surrounding
the urethra loosen, allowing the urine to pass through. These muscles can
also tighten and squeeze the urethra shut to prevent urine from passing. If
these muscles become weak or damaged, they may not be able to hold urine during
activities such as sneezing or laughing. The resulting urine leakage may be
just a small amount, or if the bladder is full, it may be more.
Urinalysis—testing urine for evidence
of infection and other abnormalities
Ultrasound—using sound waves to
measure the amount of urine remaining in the bladder after urination
Urodynamics—testing the function
of the bladder by filling it with water through a catheter (a tube placed through the urethra into the bladder)
Kegel exercises are designed to strengthen the pelvic floor muscles that support the bladder and the muscles that
surround the urethra
Behavioral treatment involves learning how to gain better control
over the muscles involved in urination and incontinence and may include charts
or diaries to track urination schedules and episodes of incontinence.
Biofeedback is designed to increase awareness of muscle tension
using electrical or pressure sensing devices.
Pelvic floor electrical stimulation uses short pulses of electrical
stimulation to strengthen the pelvic floor muscles.
Collagen injections in the tissues around the urethra can be done
to improve holding in urine.
Surgery may improve the support of the bladder and urethra. If
you think your are experiencing stress incontinence, see your doctor for an
evaluation and consideration of the best treatment for your particular symptoms.
If you think your are experiencing stress incontinence, see your doctor for an evaluation and consideration of the best treatment for your particular symptoms.
American College of Obstetricians and Gynecologists202/863-2518www.acog.org
National Institute of Diabetes & Digestive & Kidney Disease
National Kidney and Urologic Diseases Information Clearinghouse800/891-5390www.niddk.nih.gov
To find this and other JAMA Patient Pages, go to the Patient Page link
on JAMA ’s Web site at www.jama.com. A Patient
Page on urinary incontinence was published in the December 16, 1998, issue.
The JAMA Patient Page is a public service of JAMA . The
information and recommendations appearing on this page are appropriate in
most instances, but they are not a substitute for medical diagnosis. For specific
information concerning your personal medical condition, JAMA suggests
that you consult your physician. This page may be photocopied noncommercially
by physicians and other health care professionals to share with patients.
Any other print or online reproduction is subject to AMA approval. To purchase
bulk reprints, call 718/946-7424.
Sources: American College of Obstetricians and Gynecologists, National
Institute of Diabetes & Digestive & Kidney Disease, American Foundation
for Urologic Disease, American Urogynecologic Society, American Urological
Sharon Parmet, Cassio Lynm, Richard M. Glass. Stress Incontinence. JAMA. 2003;290(3):426. doi:10.1001/jama.290.3.426