Stress incontinence is due to undue sudden pressure on the urinary bladder. The common causes are obesity, current pregnancy, weakening of the anchoring muscles of the uterus, uterine displacement and weakening of the abdominal floor muscles due to multiple pregnancies and deliveries. Reduction of estrogen post menopause, surgical interventions like hysterectomy and pregnancy (uterus expands and presses the bladder) also contribute to weakening of muscles. From all of the above, it is clear that the risk factors are stacked against women and they suffer more from this problem.

Triggers
Sudden actions like sudden coughing, sneezing, laughing, heavy lifting and exercise are some of the triggers. Chronic smokers are often prone for strenuous spells of coughing and suffer from this type of incontinence.

Diagnosing Stress Incontinence
The diagnostic tests usually are a physical internal examination to determine the abdominal floor muscle strength and the strength of the bladder sphincter muscle. Blood tests to eliminate kidney dysfunction and urinary infection are also done as per requirements. Other tests are abdominal ultrasound to determine the post void urine volume and the condition of the bladder. In some cases an endoscopy of the bladder may be required to assess the internal condition of the bladder such as abnormal growths etc.

Treatment
Appropriate treatments to any organic and systemic disorders are instituted as per requirements.

• Patients are encouraged to reduce weight and stop smoking.
• The most common cause is weakness of the abdominal floor muscle and the bladder sphincter. The exercise to strengthen these muscles is known as Kegel exercises.
• First step in this regime is to identify the involved muscles. This is done by consciously trying to stop urination mid way and recognize the involved muscle. The whole is repeated without involving the abdominal muscles and interrupting normal breathing. The muscles are pulled and held tight to a count of ten and relaxed for a count of three.
• Ten repetitions is a set. The whole set is repeated as many time as possible. It is considered a good to be able to stop and hold urine to a count of ten. It may be required to increase the repetition in each set to twenty or more. A bonus in this whole exercise of strengthening the abdominal floor muscle is an enhancement of sexual performance and satisfaction.