Stress incontinence is the most common type of urinary incontinence. It causes you to leak urine during physical exertion. It can happen during exercise, coughing, laughing and sneezing. Pelvic floor exercises (Kegels) can strengthen muscles and reduce symptoms. Some people need pessaries, bladder slings or other treatments.
Stress incontinence causes urine to leak when something puts pressure on your bladder (the organ in the urinary system that holds pee). You may release small amounts of urine when you cough, sneeze or laugh. Physical exertion like jumping, running or lifting a heavy object can also cause you to pee.
Stress incontinence is the most common type of urinary incontinence. It most often affects the urinary system in people assigned female at birth (AFAB). As many as 1 in 3 people who were AFAB will experience stress urinary incontinence at some point. It’s less common for the condition to affect men, but it does happen.
More than half of people with stress incontinence also have urge incontinence. Having both stress and urge incontinence is known as mixed incontinence. An overactive bladder causes urge incontinence. This type of urinary incontinence causes you to leak urine when you feel an urgent need to pee.
Overflow incontinence is a different type of urinary incontinence. It causes you to leak urine because your bladder is too full or you can’t completely empty it.
Stress incontinence happens with sudden pressure on the bladder and urethra (the tube that carries urine from the bladder out of the body). This pressure causes the sphincter muscle inside the urethra to briefly open, allowing urine to come out. Any activity — bending over, jumping, coughing or sneezing, for example — may squeeze the bladder.
Anyone can have urinary incontinence, but the problem affects twice as many people AFAB as people assigned male at birth (AMAB). It’s estimated half of women over age 65 have stress urinary incontinence. But urinary incontinence is not a normal part of aging. It’s a sign of a problem that can get better with appropriate treatment.
Risk factors for stress incontinence include:
Leaking urine when there’s pressure on your bladder is the top sign of stress incontinence. Mild stress incontinence may cause you to leak drops of urine during activities like heavy exercise, laughing, coughing or sneezing.
With moderate to severe stress incontinence, you may leak more than a tablespoon of urine even during less strenuous activities like standing up or bending over. You may even leak urine while having sex.
Your healthcare provider will perform a physical exam (and a pelvic exam for people AFAB) and ask about symptoms. You may need to keep a bladder diary for two to three days to monitor your fluid intake, bathroom use and urine leakage. Your notes should include what you were doing before the leakage. This information can help your provider make a diagnosis.
Tests for stress incontinence include:
Yes, pelvic floor exercises (Kegels) can improve stress incontinence. These exercises strengthen the muscles that support your urinary system. It can be challenging to correctly work and strengthen your pelvic floor muscles.
A physical therapist who specializes in pelvic floor disorders can help you master the proper techniques. This provider may use biofeedback to ensure you work the right muscles. It can take four to six weeks of regular exercise to see symptoms improve.
In addition to pelvic floor exercises, these steps can also improve stress incontinence:
Stress incontinence treatments for women include:
Men are most likely to develop incontinence after prostate cancer surgery. Stress incontinence treatments for men include:
Severe stress incontinence can be embarrassing and may make you feel anxious or depressed. Adult diapers and absorbent urinary pads can catch urine leaks, but you may become self-conscious about an odor or worry that people can notice that you’re wearing them. You may not want to go out in public or be far from a restroom. Continuous urine on your skin can irritate it, leading to skin rashes and sores.
These steps may lower your chances of developing urinary incontinence:
At-home therapies like pelvic floor exercises and working with a pelvic floor physical therapist can greatly improve stress incontinence. When needed, other treatments can help significantly reduce or stop urine leakage.
You may want to ask your healthcare provider:
Stress incontinence that is mild can progress to moderate or severe. This is most likely to happen if you gain a lot of weight (or don’t lose excess weight). Symptoms may worsen if you continue to smoke or don’t take other steps to manage the condition.
These two types of urinary incontinence have different causes and symptoms:
A note from Cleveland Clinic
Depending on the severity of the stress incontinence, leaking urine may be an inconvenience or embarrassing. You may become hesitant to be far from a bathroom. Or you may choose not to exercise for fear of leaking urine. Many people can improve their symptoms by regularly doing pelvic floor exercises. For moderate to severe stress incontinence, devices, injections or surgical procedures can help.
Last reviewed by a Cleveland Clinic medical professional on 11/05/2021.
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