Stress Incontinence

Weakening of Pelvic Floor Muscles and Ligaments

These muscles and ligaments support the urethra and bladder neck. When they weaken, they cannot maintain the urethra and bladder in the correct position, resulting in incontinence.

Pregnancy and Childbirth

Pregnancy and childbirth are major risk factors. During pregnancy, the baby's weight puts pressure on the pelvic floor muscles. Pregnancy, childbirth, and especially vaginal delivery can cause trauma to the muscles and nerves of the area.

Menopause and Hormonal Changes

Menopause often worsens incontinence due to decreased estrogen. This hormonal change affects the elasticity and strength of tissues around the urethra and bladder.

Other Risk Factors

• Obesity: Extra weight increases pressure on the bladder
• Aging: Natural weakening of muscles with age
• Heredity: Family history of incontinence (collagen and tissue quality)
• Chronic cough: From smoking or allergies

Typical Symptoms

Stress incontinence manifests with urine leakage when intra-abdominal pressure increases, in situations such as:

• Coughing and sneezing
• Laughing or crying
• Lifting weights or exercising
• Running or other athletic activities
• Rising from a sitting position
• Movement after staying in one position

Incontinence is characterized as:

1. Mild: Leakage only during intense activities
2. Moderate: Leakage during daily activities such as walking
3. Severe: Leakage even during light movements

Medical Examination

The diagnosis of stress incontinence includes:

• Detailed history: Symptoms, frequency, and severity
• Physical examination: Pelvic floor assessment
• Cough test: Observation of leakage during coughing
• Urine tests: To rule out infection

Special Tests

• Urodynamic study
• Bladder ultrasound
• Cystoscopy

Conservative Management

• Kegel exercises are the first line of treatment for mild forms of incontinence. These exercises strengthen the pelvic floor muscles.

• Lifestyle changes such as weight loss that helps reduce pressure on the bladder and smoking cessation which reduces chronic cough

Surgical Treatment

When conservative methods are insufficient, surgical options are considered:

• Urethral Bulking Injections
  This is the least invasive method without complications, lasts 5-10 minutes, and success rates exceed 50%
• Tension-Free Tapes (TVT, TVT-O, Autologous Fascial Sling AFS)
  This is the most common surgical procedure for stress incontinence. It involves placing a synthetic tape that supports the bladder neck. The success rate of this procedure is approximately 90%.
• Burch Colposuspension
  A surgical procedure that lifts and stabilizes the bladder neck. Similar to tapes, the success rate is approximately 90%.

Stress incontinence is a manageable condition. With timely diagnosis and appropriate treatment, the majority of individuals can return to normal function. A scientific approach by a specialized urogynecologist offers proper diagnosis and selection of the appropriate therapeutic method, which are key to successful management of this common and unpleasant condition.

Trust the experience of Kostis Nikolopoulos for safe and effective treatment.

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