Stress incontinence, the most common type, refers to urine leaking during activities that temporarily increase the pressure within the abdomen, such as exercising, sneezing, laughing, or coughing. Half of all women experience this problem at some time in their lives.
Anatomically, stress incontinence is the result of a fallen bladder, meaning the bladder, which normally sits high above the pelvic floor held in place by a triangular sheet of muscle, begins to sag from weakened pelvic muscles. In this position, the internal sphincter can no longer close properly because of weakening muscles, and the external sphincter takes over the entire job of holding in urine. Most of the time, the external sphincter manages to retain urine, but sudden pressure within the abdomen can cause it to temporarily lose its grip.
Stress incontinence can occur when a person exercises, sneezes, laughs, or coughs.
Because men's pelvic muscles are configured differently than women's, men are less susceptible to fallen bladder. An exception sometimes happens when men undergo prostate surgery, they may experience stress incontinence if their external sphincter is damaged during the surgical removal of the prostate gland.
Other than this exception, stress incontinence most often affects women, particularly after childbirth. During childbirth, muscle fibers around the bladder may be weakened and never completely return to their original strength. Menopause can also add to the problem by reducing the level of estrogen, a hormone that helps maintain muscle tone. Additionally, the pull of gravity sometimes causes the weight of the abdominal organs to put pressure on the pelvic floor muscles. This gravitational pull is worse in patients who are obese.
This condition has been successfully treated by a procedure known as TVT