Do you cross your legs before you sneeze or avoid laughing too hard because you’re afraid of leaking? Many women experience urinary leaks, known as stress urinary incontinence (SUI), when pressure on the bladder—like laughing, coughing, or sneezing—forces it open just enough to allow urine to escape. If this sounds familiar, know that while SUI may be common, it’s not “normal.” There are plenty of effective treatment options available, and they can make a real difference.
What is Stress Urinary Incontinence?
Stress incontinence occurs when the muscle that closes off the bladder, known as the urethral sphincter, weakens. When this muscle doesn’t stay closed under pressure, a bit of urine can escape. Women often first notice this after childbirth or as they age and lose hormones that support the bladder muscle. Other factors that can worsen SUI include:
Weight gain: Extra pressure on the bladder.
Strenuous jobs: Frequent heavy lifting.
Chronic cough: From smoking or conditions like allergies.
Constipation: Repeated straining can weaken pelvic muscles.
Even those without children can develop SUI, often finding symptoms worsened by life events, such as menopause or extended illness with coughing, as in post-COVID cases.
Treatment Options for Stress Incontinence
The good news? There are multiple treatments for SUI, from exercises to procedures, depending on the severity of symptoms and personal preference.
1. Strengthening the Bladder Muscle
Kegel Exercises: Kegels involve contracting the pelvic floor muscles as if trying to stop gas or urine flow. While useful for mild symptoms, Kegels alone may not be enough for noticeable improvement in SUI.
Pelvic Floor Therapy: Pelvic therapy goes a step beyond Kegels by actively challenging these muscles to strengthen. Options include:
Electrical Stimulation: A wand inserted vaginally emits mild pulses to stimulate muscle contractions. Regular treatments can improve symptoms, though they may not thicken or lift the muscles significantly.
Electromagnetic Stimulation (Emsella Chair): Sitting on this specialized chair directs a cone of energy into the pelvic floor to engage the muscles deeply. MRI studies show muscle thickening and lift from this type of therapy, providing long-term improvement for many patients.
Both therapies are most effective with ongoing maintenance to maintain the strengthened muscles.
2. Vaginal Support Devices (Pessaries)
For those needing more than muscle strengthening, a pessary can add support to the bladder closure muscle. Shaped like a ring with a knob, it sits under the bladder, applying gentle pressure to prevent leaks. Pessaries are:
Custom-fitted: Inserted and removed at home, as needed.
Flexible in use: You can wear a pessary only during activities that trigger leaks, such as exercise or specific physical tasks.
The over-the-counter Poise Impressa is a similar device, fitted like a tampon to apply pressure to the bladder muscle. Impressa is sized through a fitting kit (small, medium, or large) and available at many major retailers.
3. Surgical Options for Severe Incontinence
When lifestyle changes, exercises, and pessaries aren’t enough, surgical solutions are highly effective:
Mid-Urethral Sling: A small mesh sling placed around the bladder closure muscle, holding it in place to prevent leaks. The sling procedure is minimally invasive, with high success and low complication rates. This option provides long-lasting results—up to ten years or more for many patients.
Fascial Sling: For patients who prefer a non-mesh option, a fascial sling can be made from the patient’s own tissue. While more invasive and with a longer recovery time, it offers a non-synthetic solution.
The Burch Procedure is another surgical option involving abdominal surgery to lift and stabilize the bladder from above. It’s less common but useful in complex cases.
4. Urethral Bulking Injections
For patients seeking a non-surgical, in-office solution, urethral bulking injections may be a fit. This involves injecting a gel-like material into the urethra to tighten it from the inside. It’s a quick, minimally invasive option that typically needs repeating every 1–3 years but is effective for many patients.
Common Concerns About Mesh in Slings
If you’re worried about mesh complications, it’s essential to know that the FDA has confirmed the safety of mid-urethral slings for incontinence. The complications linked to mesh apply specifically to larger pieces used in vaginal prolapse repairs. The mesh used in slings is small, minimally invasive, and has undergone extensive research.
Choosing the Right Option
With so many treatments available, it’s possible to find an approach that works for your lifestyle, comfort level, and severity of symptoms. From non-invasive pessaries to long-lasting surgical options, you can regain confidence and live without the worry of leaks. Consult with a specialist to determine the best course of action and get personalized guidance on treatment options.
You don’t have to accept leaking as a “normal” part of life. Understanding the options available, from exercises to surgery, empowers you to find relief and improve your quality of life.
Listen to Dr Jackson go into detail about this topic! You can hear the full episode on her podcast, Ageless and Outrageous. Be sure to like and follow so you don’t miss an episode!
The team at Foundations at Maitland are all vaginal and sexual health experts who have been helping men and women have a more fulfilling and intimate sex life for over 20 years. If you are considering vaginal rejuvenation, you deserve to only see an expert.
SCHEDULE YOUR VAGINAL REJUVENATION CONSULTATION AT FOUNDATIONS AT MAITLAND
At Foundations at Maitland, in Maitland FL, we offer a full range of non-surgical treatments to help you reach your aesthetic, wellness, and sexual goals. Our providers are highly trained and experienced. We are led by our double-board certified surgeon, Dr Kristin Jackson, who has personally developed all treatment protocols and is closely involved in the day-to-day operations of our medical spa. With her extensive training in all non-surgical cosmetic treatments as well as over 20 years of surgical experience, Dr Jackson is uniquely qualified to ensure our medical spa provides you with the highest standards of quality care and safety.
If you are looking for vaginal rejuvenation doctors near you, we can help! Contact us today for your complimentary consultation!
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