Stress Urinary Incontinence (SUI) – Causes, Diagnosis & Treatment in Delhi

About Stress Urinary Incontinence (SUI)

Stress Urinary Incontinence (SUI) occurs when weakened pelvic floor muscles fail to adequately support the bladder and urethra. As a result, physical pressure such as coughing, laughing, or exercising causes involuntary urine leakage.

A common cause is childbirth, though age, obesity, and certain surgeries also play a role. The first-line treatment involves pelvic floor strengthening exercises, with options for surgical intervention or medication in persistent or severe cases.

At MASSH Group of Hospitals, we provide personalized, evidence-based care ranging from non-invasive therapies to minimally invasive surgical solutions tailored to each patient’s unique needs.

Stress Urinary Incontinence (SUI): Signs and Symptoms

SUI presents with distinct and often predictable symptoms. Here's a detailed breakdown:

1. Urine Leakage During Physical Activity

• Description: Involuntary leakage occurs during activities that raise abdominal pressure.
• Triggers: Coughing, sneezing, laughing, exercise, lifting, or standing up.
• Pattern: Leakage is brief and stops once the activity ends.
• Severity: Can range from a few drops to a significant gush.
• Context: Often anticipated by patients during specific motions.

2. No Urge to Urinate

• Description: Unlike urge incontinence, there’s no strong sensation to urinate before leakage.
• Cause: Mechanical weakness, not bladder overactivity.

3. Dampness or Wetness

• Description: Post-leak wetness noticed on clothing or skin.
• Impact: May require frequent pad or underwear changes.

4. Emotional Distress or Social Avoidance

• Description: Fear of leaks leads to lifestyle restrictions.
• Examples: Avoiding gym, social events, or intimacy.

5. Pelvic Pressure or Discomfort

• Description: A feeling of heaviness, especially with associated prolapse.
• Cause: Weakened pelvic supports.

6. No Leakage at Rest

• Description: Leakage occurs only with movement or strain—not while lying down or sitting.

7. Worsening With Risk Factors

Description: Symptoms intensify with age, weight gain, chronic cough, or after surgery.

Stress Urinary Incontinence (SUI) in Women vs. Men

• Women: Far more common due to childbirth, shorter urethra, and hormonal changes.
• Men: Mostly linked to prostate surgery (e.g., prostatectomy). Leakage may occur during exertion or positional changes.

Common Causes of Stress Incontinence

• Childbirth: Vaginal deliveries may stretch or injure pelvic muscles and nerves, increasing SUI risk.
• Aging: Muscle tone and estrogen levels decline, especially post-menopause.
• Obesity: Extra weight adds constant pressure on pelvic structures.
• Prostate Surgery (Men): Procedures like prostatectomy can weaken sphincter function.
• Chronic Cough or Lung Conditions: Long-term coughing from smoking, asthma, or COPD increases risk.
• High-Impact Physical Activity: Sports like running or gymnastics can strain pelvic muscles, especially in younger women.
• Family History: Genetic predisposition may influence tissue strength and pelvic support.
• Menopause: Estrogen deficiency affects tissue elasticity and muscle tone.
• Neuromuscular Conditions: Conditions like multiple sclerosis or spinal injuries may contribute in complex cases.

Diagnosis of Stress Urinary Incontinence (SUI)

Our specialists at MASSH Group of Hospitals use a multi-step diagnostic process:

• Medical History: Focused on triggers and patterns of leakage.
• Pelvic or Rectal Exam: Assesses muscle tone and organ support.
• Cough Stress Test: Observes leakage with a full bladder.
• Urinalysis: Rules out infection or hematuria.
• Bladder Diary: Tracks leakage, activity, and timing.
• Post-Void Residual Volume: Ensures bladder empties completely.
• Urodynamic Studies (if needed): Measures bladder and urethra pressures.
• Pad Test: Objectively quantifies urine loss during activity.

Treatment Options at MASSH Group of Hospitals

1. Pelvic Floor Exercises (Kegel Exercises)

• Strengthen muscles that support the bladder and urethra.
• Recommended as first-line treatment.
• Effective in up to 60% of patients.

2. Lifestyle Modifications

• Weight Loss: Even a 5–10% reduction can significantly reduce symptoms.
• Manage Cough or Constipation: Reduces pressure on pelvic floor.
• Limit Bladder Irritants: Caffeine and alcohol may worsen symptoms.

3. Medications

• Often used when exercises alone aren’t enough and surgery isn’t preferred.
• May help improve urethral tone.

Surgical Treatments at MASSH Group of Hospitals

We offer state-of-the-art, minimally invasive procedures for long-term relief:

TOT (Trans-Obturator Tape)

• What it is: Mesh tape placed under the urethra via the groin (obturator foramen).
• Duration: 30–45 minutes.
• Recovery: 1–2 weeks.
• Success Rate: 85–90%.
• Benefits: Lower bladder injury risk than older methods.

TVT (Tension-Free Vaginal Tape)

• What it is: Mesh support placed behind the pubic bone through vaginal and abdominal incisions.
• Success Rate: 85–90%.
• Recovery: Typically within 1–2 weeks.
• Considerations: Slightly higher risk of bladder injury than TOT (5–10%).

Our expert urology teams will help choose the most appropriate solution based on severity, anatomy, and personal preference