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Urinary incontinence affects millions of women of all ages and social and economic levels, although it occurs more often in older women than in young women. The two basic forms of incontinence include urge incontinence and stress incontinence. This page covers stress incontinence, which is the most common. It occurs when the muscle (sphincter) that holds the bladder’s outlet closed is not strong enough to hold back the urine.
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Problems with the way the sphincter muscle opens and closes can cause stress incontinence. In addition to chronic coughing, smoking and obesity, the following physical changes to the body may also cause stress incontinence:
Muscles in the pelvis can weaken and cause the bladder to drop down into a position that prevents the urethra from closing completely. This results in urine leakage.
Urinary stress incontinence occurs upon a sudden movement or activity, such as coughing, sneezing, laughing or lifting, and causes abdominal pressure on the bladder, which triggers a small amount of urine to leak. The leakage may be as little as a drop or two, a “squirt,” or even a stream of urine.
A urologist will perform a detailed history and physical exam, so it is helpful if the patient keeps a diary for a few days beforehand to record times of urination, the amount of urine, leakage, and foods and beverages consumed. The physician may also perform one of several tests: