Stress incontinence occurs when the muscles and other tissues that support the bladder (pelvic floor muscles) and the muscles that regulate the release of urine (urinary sphincter) weaken.

The bladder expands as it fills with urine. Normally, valve-like muscles in the urethra — the short tube that carries urine out of your body — stay closed as the bladder expands, preventing urine leakage until you reach a bathroom. But when those muscles weaken, anything that exerts force on the abdominal and pelvic muscles — sneezing, bending over, lifting, laughing hard, for instance — can put pressure on your bladder and cause urine leakage.

Your pelvic floor muscles and urinary sphincter may lose strength because of:

  • Childbirth. In women, poor function of pelvic floor muscles or the sphincter may occur because of tissue or nerve damage 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 sphincter lies directly below the prostate gland and encircles the urethra, a prostatectomy may result in a weakened sphincter.

Contributing factors

Other factors that may worsen stress incontinence include:

  • Illnesses that cause chronic coughing or sneezing
  • Obesity
  • Smoking, which can cause frequent coughing
  • Excess consumption of caffeine or alcohol
  • High-impact activities over many years
  • Hormonal deficiency
Sep. 16, 2014

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