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Causes
By Mayo Clinic staff
Stress incontinence occurs because of poor function in the muscles that support the bladder or control the release of urine. Sometimes both muscle groups are involved. The bladder expands as it fills with urine, but valve-like muscles at each end of the urethra — the short tube through which urine flows to exit your body — normally stay closed, or contracted, preventing urine release until you reach a bathroom. When the muscles supporting the bladder are weak, however, pressure can trigger urine release before you're ready. Problems with the valves themselves (the urinary sphincters) may have the same effect.
Your bladder may not even feel unusually full when you have urine leakage due to stress incontinence. Anything that exerts force on the abdominal muscles — sneezing, bending over, lifting, laughing hard — also puts pressure on your bladder.
Your urinary sphincter and pelvic floor muscles may lose tone because of:
- Childbirth. In women, poor function of pelvic floor muscles or the sphincter may occur because of tissue or nerve damage incurred during delivery of a child. Stress incontinence from this damage may begin soon after delivery or occur years later.
- Prostate surgery. In men, the most common factor leading to stress incontinence is the surgical removal of the prostate gland (prostatectomy) to treat prostate cancer. Because the prostate gland encircles the urethra, a prostatectomy results in less urethral support.
Contributing factors
Other factors that may worsen stress incontinence include:
- Urinary tract infection
- Illnesses that cause chronic coughing or sneezing
- Obesity
- Smoking, which can cause frequent coughing
- Diabetes, which can cause excess urine production and nerve damage
- Excess consumption of caffeine or alcohol
- Medications that cause a rapid increase in urine production
- Sports, such as tennis or running
- Fong E, et al. Urinary incontinence. Primary Care Clinics in Office Practice. 2010;37:599.
- Nitti VW, et al. Urinary incontinence: Epidemiology, pathophysiology, evaluation, and management overview. In: Wein AJ. Campbell-Walsh Urology. 9th ed. Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/214316744-4/1038180294/1445/63.html#4-u1.0-B978-0-7216-0798-6..50062-5--cesec2_4438. Accessed Aug. 17, 2010.
- DuBeau C. Clinical presentation and diagnosis of urinary incontinence. http://www.uptodate.com/home/index.html. Accessed Aug. 17, 2010.
- DuBeau C. Epidemiology, risk factors, and pathogenesis of urinary incontinence. http://www.uptodate.com/home/index.html. Accessed Aug. 17, 2010.
- DuBeau C. Treatment of urinary incontinence. http://www.uptodate.com/home/index.html. Accessed Aug. 17, 2010.
- Urinary incontinence. WomensHealth.gov. http://www.womenshealth.gov/faq/urinary-incontinence.cfm. Accessed Aug. 17, 2010.
- Urinary incontinence in women. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/uiwomen/index.htm. Accessed Aug. 17, 2010.
- Anderson CF (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 19, 2010.
- Clinician training & resources FAQ. FemSoft Insert. http://www.femsofttraining.com. Accessed Sept. 28, 2010.
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