Female Stress Urinary Incontinence

Stress urinary incontinence (SUI) isn’t a disease. Rather, it is a symptom of weakened or damaged muscles and tissues that normally support the bladder and urethra.

SUI is one of the most common types of urinary leakage in women and can range from a few drops to large amounts that disrupt daily life. It happens when urine leaks during activities that increase abdominal pressure, such as laughing, sneezing, coughing, lifting, or exercising.

While common, SUI is not something you have to live with. Effective treatments are available in the Charlotte area and in West Columbia, SC.

The urethra is the tube that carries urine from the bladder out of the body. Normally, pelvic floor muscles and a ring-like sphincter work to keep the urethra closed. If these structures weaken or become stretched, they may not stay closed when abdominal pressure increases. Weakening or stretching may happen due to:

• Pregnancy and childbirth
• Menopause, where lower estrogen levels can thin tissue and reduce support
• Procedures such as a hysterectomy
• Coughing and constipation, which can strain muscles
• Having extra body weight that increases abdominal pressure

With SUI, you may experience unexpected dribbling or significant wetness. Symptoms can range from an occasional leak to more frequent accidents that become very disruptive.

Typical signs include:

• Leaking urine when you cough, sneeze, laugh, or exercise
• Leakage when bending, lifting, or standing up
• Leaks that happen suddenly, with no warning
• Inability to stay dry during physical activity

Over time, these symptoms become increasingly challenging to live with. They can start to impact activities and confidence, and interfere with comfort. The good news is, there are safe, proven ways to improve bladder control.

Your doctor will start by discussing your symptoms and medical history. Common evaluation steps may also include:

• Physical and pelvic exam to assess muscle strength and rule out other causes
• A bladder diary to record how much and how often you urinate, and when leakage occurs
• Urine test to rule out infection
• Cough stress test to check for visible leakage
• Urodynamic testing to measure bladder and sphincter function

For some women, non-invasive strategies lead to a considerable improvement or even complete control.

Pelvic floor muscle therapy (Kegel exercises)

A physical therapist can teach you how to isolate and strengthen the pelvic floor muscles correctly. Consistent, guided training often improves bladder control within weeks to months.

Lifestyle strategies

Your doctor may recommend lifestyle adjustments that help reduce bladder pressure and leakage, such as:

• Maintaining a healthy weight to reduce pressure on the bladder
• Quitting smoking to decrease chronic coughing
• Treating constipation
• Avoiding excessive straining
• Limiting caffeine, alcohol, and carbonated beverages if they worsen leakage
• Emptying your bladder before activities that tend to trigger leaks

Vaginal pessary

A vaginal pessary is a small, flexible silicone device that provides internal support to the bladder neck and urethra. Reinforcing these structures helps prevent urine leakage during activity or strain. Your doctor will fit the device for comfort and teach you how to manage it between checkups.

Topical estrogen therapy

After menopause, vaginal estrogen cream or ring can strengthen tissues around the urethra and vagina. This improves muscle tone and urethral closure.

If pelvic floor therapy and lifestyle changes haven’t helped enough, there are safe and effective procedures available. The choice depends on the severity of your leakage and your medical history.

Midurethral sling

This is the most common and successful surgery for female stress urinary incontinence. A small strip of soft synthetic mesh is placed under the middle of the urethra. The sling acts like a hammock, giving gentle support so the urethra stays closed under pressure. Recovery is usually quick, and most women notice a major improvement in leakage.

Some women worry about mesh. However, reports of complications generally apply to mesh used for vaginal prolapse repair, not to midurethral slings for stress incontinence.

Urethral bulking injections

With a bulking injection, a gel-like material is injected around the urethra to help it close more tightly. The treatment takes only a few minutes and is done in an outpatient setting. Results are best for mild leakage and may fade over time, so repeat injections are sometimes needed.

Bladder neck suspension or Burch procedure

This surgery lifts and secures the tissues around the bladder neck to improve support. It’s typically performed through small abdominal incisions and may be recommended when a sling isn’t ideal.

SUI can impact your physical and emotional well-being, but it is not something you have to simply tolerate. Many women regain control through individualized plans that start conservatively and progress as needed. Even small improvements can restore comfort.

1. Can stress incontinence be cured without surgery?

Yes. Many women regain control with pelvic floor muscle therapy, vaginal estrogen, and pessary use. Early intervention, maintaining a healthy body weight, and consistent exercise can greatly improve results.

2. How soon after childbirth can I start pelvic floor exercises?

You can begin gentle pelvic floor contractions as soon as you’re comfortable, often within days of a vaginal delivery, unless advised otherwise. Starting early helps strengthen muscles and reduce leakage by improving coordination and bladder control.

All of our providers treat Female Urinary Stress Incontinence.