Incontinence is the involuntary loss of urine. It affects as many as ten million adults, most of whom are women. One of the most common types is stress incontinence, which results from anything that puts a physical stress on the bladder, like laughing, coughing, or sneezing. Exercise or lifting can also bring on stress incontinence. When pelvic muscles are weakened, they can no longer hold the urethra (you-REE-thruh) closed properly, and any strain may cause urine to leak out. A number of conditions can lead to stress incontinence. Damage to pelvic muscles or nerves during pregnancy and childbirth, thinning of vaginal tissues during menopause, and excess weight in the abdomen are all possible contributors. To evaluate stress incontinence, doctors may perform a test where a cotton swab is inserted into the urethra, and the patient is asked to cough and strain. The presence of urine on the swab indicates incontinence. Many women are reluctant to seek treatment for this problem. But they shouldn't be. Incontinence is more common than one might think, and can usually be improved. Many non-surgical methods are available, including Kegel exercises to strengthen pelvic muscles, and medication. When prolapse or dropping of the bladder is severe, surgical techniques may be used to reposition the bladder. One type, called the abdominal bladder suspension, is over 80 percent successful. For more information on stress incontinence, consult a health care provider.
