Stress Urinary Incontinence (SUI)

The International Continence Society (ICS) defines stress urinary incontinence as “the complaint of involuntary leakage on effort or exertion, or on sneezing or coughing”.

Stress urinary incontinence (SUI) is a very common medical condition caused by weakening of urethral sphincter muscles and pelvic floor muscles, which are used to keep your urethra closed and you continent. This weakening leads to leakages of urine when coughing, sneezing, laughing, exercising and other activities which raise the pressure (stress) inside your abdomen; hence the name stress urinary incontinence.

More specifically, there are two types of SUI: urethral hypermobility and intrinsic sphincter deficiency (ISD). In the case of urethral hypermobility, the urethra shifts positions due to an increase in abdominal pressure. On the other hand, ISD refers to the inability to effectively seal off the sphincter, the ring of muscles whose main job is to remain tightened, keeping urine in the bladder. It is generally believed that many women with SUI have some degree of ISD.


SUI is the most common form of incontinence in women. Approximately 1 in 3 women will experience some form of stress incontinence during their lifetime. Too many women live with this condition, embarrassed to talk about it, seek help or believing that it is an unavoidable part of having children and/or aging. This is not the case.

Stress urinary incontinence is treatable

SUI is treatable, it is not a taboo. It is imperative to seek advice and help for any condition which negatively affects your quality of life, such as SUI.

SUI can involve mild to severe urine loss and can affect all parts of your life, such as social interactions, sex life, ability to work, travel and play sports. The physical, emotional and social impact should also not be underestimated.

Causes of stress urinary incontinence

Some of the causes of SUI are known to be:

  • Pregnancy and childbirth
  • Hormonal deficiency
  • Prostrate surgery
  • Obesity
  • Smoking
  • Excess consumption of caffeine or alcohol
  • High-impact activities over years
  • Chronic coughing or sneezing

Treatment options

There are many factors associated with SUI as well as treatment options. It is important that you seek medical advice when looking for treatment options to suit your condition. Doing nothing is not an option! Treating the symptoms of SUI early could greatly decrease the chance of your condition worsening over the coming years.

The most widely recognized treatment options for SUI range from conservative to surgical treatments:

  • A wide range of products and devices are available for bladder incontinence. They include pads, bed and chair protection, catheters, skin care and hygiene products and specially adapted clothing. They are designed to alleviate your symptoms but do not treat the cause of your incontinence.
  • Pelvic Floor Muscle Exercises (PMFE) also known as Kegels, are exercises designed to strengthen your pelvic floor muscles. These muscles help support the bladder and other organs and by exercising your pelvic floor muscles and making them stronger, you can reduce SUI related urine loss. PFME are essential exercises for all women and not just for treating the symptoms of SUI; they should be as much a part of daily living activities as brushing teeth! They can be beneficial in reducing the symptoms of mild SUI but must be carried out correctly.
  • Surgery, such as the placement of a sling (synthetic mesh), is used to help restore support under the bladder and urethra. Slings are the most common surgical procedure to treat stress urinary incontinence. All surgical procedures involve one or more surgical incisions. Surgery is not a solution for all and some women may be unwilling or unable to undergo a surgical procedure, for example women who wish to have (more) children or elderly women who have a greater associated morbidity and are at risk of a longer recovery period as a result of surgery.
  • Minimally-invasive treatments such as urethral bulking agents, are injected around the urethra effectively narrowing the urethra, by adding bulk and allowing it to withstand the increases in pressure when coughing, laughing, exercising and so on. The procedure is most commonly performed as an “out-patient” procedure lasting around 30 minutes.
  • Urolon™ is a new class of bulking agent. Similar to other urethral bulking agents it is minimally-invasive and injected via a cystoscope.