Treatment Options for Stress Urinary Incontinence

Stress urinary incontinence (SUI) is characterized by the loss of voluntary control over urination when coughing, sneezing, or laughing or during any form of physical exertion such as running and jumping.

SUI is a health condition that predominantly affects the female population, and it is caused by changes to the female anatomy through vaginal childbirth, weight gain, or aging. These experiences in a woman’s life lead to the weakening of pelvic floor muscles and, ultimately, to the urethral closure mechanism that controls urination. The bladder and urethra are both supported by pelvic floor muscles. When these muscles are weakened by vaginal delivery or other causes, exertion on the abdominal and pelvic muscles apply pressure to the bladder and lead to urine leakage – the main symptom of SUI.

There are many treatments available for SUI, including behavioural modifications, medication, physical therapy, surgical treatments, and laser therapy.

Behavioural therapy consists of changes in lifestyle that can help reduce the frequency of urine leakage, but it does not cure SUI. Behavioral therapy includes altering the amount of daily fluid intake, urinating more often, avoiding certain physical movements that trigger leakage, and ingesting more fibre to avoid constipation, as it may worsen symptoms. It is also important to quit smoking and avoid alcoholic and caffeinated drinks, as they are diuretics and increase the need for urination. The modifications will be different for each patient, dependent on their health and the severity of the condition. For instance, diabetic patients are also recommended to lose excessive weight and have strict control over their blood glucose levels.

Medication is available to treat mild to moderate cases of SUI. Anti-cholinergic medications are typically prescribed to relax the bladder’s muscles or anti-muscarinic drugs that block bladder contractions. Patients may also receive other medications such as beta-agonists and anti-depressants as muscle relaxants.

Physical therapy is an option for treating SUI, using exercises to strengthen the pelvic floor muscles, such as biofeedback and Kegel exercises. Biofeedback trains an individual to learn, identify, and control the pelvic floor muscles, helping people affected with SUI to regain control over urination. Kegel exercises can help build and maintain strong muscles surrounding the urethra and vagina.

Usually as a last resort, surgery is an option to treat SUI. There are various surgical techniques. If the SUI is due to vaginal atrophy and bladder prolapse, an anterior vaginal repair surgery can restore the weak and sagging vaginal muscles. If the muscle sphincter o the bladder is weak and causing the leakage, artificial urinary sphincters can be inserted. Other surgical techniques that alleviate SUI provide support to the urethra and include bulking injections, tension-free vaginal tape, and urethral/vaginal sling procedures.

As a non-surgical alternative to invasive surgery, vaginal laser therapy has recently risen in popularity for SUI as technology advances. Laser treatments such as IncontiLase by Fotona have resulted in significant improvements after 3 months, with 94% of patients reporting reduced frequency of urine leakage and 68% of patients experiencing a complete cure of the condition.

SUI can be treated with a laser that gently stimulates re-growth and re-structuring of collagen within the vagina and urethra. This results in the thickening and tightening of the region and ultimately reduces urine loss and permits better control over urination.

If you are experiencing SUI, it is important to speak to a gynecologist about your concerns. At the Torgerson clinic, we would like to invite you to schedule an appointment with our gynecologist, Dr. Colleen McDermott. Together, we can discuss more about the new painless and effective laser therapy as an available treatment option and help you get back to normal.

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