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Stress incontinence is a urinary condition in which there is a loss of urine that occurs during physical activity, including things like exercise, laughing, sneezing or coughing.
The ability to control urination depends on having a normal lower urinary tract function, including the bladder and the pelvic floor, a normal kidney and a normal nervous system. You need to recognize the urge to urinate and keep your bladder as empty as possible in order to prevent having worsened stress incontinence.
Muscles contributing to continence of the urine include the bladder sphincter, which is a circular muscle that surrounds the urethra. It must be intact and strong to maintain the two cups or more of bladder contents. The detrusor muscle of the bladder wall needs to be continually relaxed in order to prevent contraction of the urinary bladder and allows the bladder to expand. These muscles are weak or have poor innervation in the pelvis and the sphincter cannot keep urine from exiting the bladder during times of increased pelvic pressure.
Urethral muscle weakening can also cause urinary incontinence from increased stress in the pelvis. This can be due to an injury to the urethra, certain medications or surgery to the prostate or pelvic area. Urinary continence from stress incontinence is far more common in women than in men but can be a problem for both genders. Stress incontinence is the most common type of urinary incontinence in women.
Stress incontinence is made worse by having had childbirth, chronic coughing such as with asthma or chronic bronchitis, being female, being obese, being a smoker or growing older.
Common symptoms related to stress incontinence include the involuntary urinary loss secondary to lifting heavy objects, engaging in physical activity such as running, exercising, sneezing, standing up and coughing. You can have maceration of the skin secondary to chronic wetness in the urethral area.
Doctors can diagnose stress incontinence by performing a complete history and physical examination. A genital or pelvic exam can show skin maceration and muscle laxity of the pelvic muscles. A rectal exam can show weakness of the rectal muscles. In women, a uterine prolapse may be taking place. The bladder and urethra can bulge into the vaginal vault. The doctors exam can also be done using a cystoscopy or camera exam of the bladder, a Pad test, which weighs a pad before and after a period of time to measure the urinary output. A pelvic or abdominal ultrasound can be performed that can reveal uterine fibroids or bladder abnormalities. Urodynamic testing can show how a person urinates using special electrical equipment and a urinalysis can show the presence of a bladder infection. X-rays with dye can show leakage of urine or bladder abnormalities. The patient can be asked to cough to see how much urine comes out with a full bladder. A Q-tip test can be done to measure the angle of the urethra and the bladder. If this is greater than 30 degrees, it means the muscles are weak and stress incontinence is likely.
The treatment of stress incontinence depends on how severe the condition is. You might be asked to stop smoking as this can contribute to stress incontinence. Caffeinated beverages should be avoided as should alcoholic beverages. You should keep track of the amount of times you urinate involuntarily each day to help the doctor decide on the severity of the disease.
There are four major types of treatment for stress incontinence, which include behavioral changes, pelvic floor muscle strengthening, surgery and medications. You need to empty your bladder frequently and avoid overstretching the bladder. You should avoid jumping movements and regulate your stools with laxatives or extra fiber. You should lose weight if you are overweight. Your blood sugar should be in a normal range if you are diabetic and you should avoid eating or drinking foods that irritate the bladder, including citrus beverages, carbonated beverages, and spicy foods.
Kegel exercises can prevent stress incontinence and treat it, too. These strengthen the urethral sphincter. A pelvic or vaginal cone can be used along with Kegel exercises in order to make sure the exercises are being done sufficiently. Biofeedback can help as well to increase the pelvic floor musculature. Electrical stimulation can increase pelvic floor muscle strength.
Medications include anticholinergic medications, which relax the bladder and antimuscarinic agents, which block contractions of the bladder muscles. Alpha-adrenergic agonists increase sphincter tone and can improve symptoms.
In severe cases, surgeries can be done to strengthen the muscles, suspend the bladder better and improve the symptoms of bladder control.
If you have suffered physically, mentally or financially, you should consider making an accident compensation claim. For telephone advice at no cost from specialist personal injury solicitors just call the helpline. Our stress incontinence solicitors will assess the strength of your claim and will advise you on your potential award of compensation without any further obligation.LAWYER HELPLINE: ☎ 1800 339 958
The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here