A woman with the "stress" type may experience urine loss during exercise, coughing, sneezing, laughing or any body movement that puts pressure on the bladder. Nearly half of all urinary incontinence cases are stress incontinence.
Stress incontinence occurs when pelvic muscles and ligaments have been damaged, typically by pregnancy, childbirth, radiation, trauma, prior surgery or hormonal changes. Currently, no medication is available to treat stress incontinence.
Exercises known as "Kegels" can increase the size and strength of the pelvic floor muscles. When done correctly, Kegel exercises have been shown to be 50 percent effective in improving urinary incontinence. Biofeedback can help instruct the patient on which muscles are the proper ones to contract.
Often made of rubber, plastic or silicone, a pessary is a medical device, similar to a diaphragm, inserted into the vagina to provide structural support. It is most commonly used to treat prolapse of the uterus but can also be used to treat stress urinary incontinence.
TVT (tension-free vaginal tape), TOT (transobturator tape) and mini sling procedures are used to lift a woman's sagging bladder or urethra into normal position, allowing for closure of the urethra during increased abdominal pressures. The procedures place a narrow band of tape under the urethra, supporting it like a hammock.
Unlike "open" surgeries, they require only very small incisions. Procedural pain is minimal and patients can resume normal, non strenuous activities shortly after. They are generally safe (with only rare complications) and are effective in over 90 percent of cases.
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