Stress incontinence

In the case of stress incontinence, the sphincter system at the exit of the urethra is not strong enough and so does not close properly. This means that any sudden physical strain (in this context called "stress"), such as sneezing, coughing, laughing or even intense physical movements trigger involuntary loss of urine. This is because the physical strain leads to a pressure increase in the pelvis minor and to a pressure increase in the bladder. This increased pressure overrides the diminished ability of the sphincter system to close properly and leads to an involuntary loss of urine. The degrees of severity I, II and III are defined, whereby in the third and last one, loss of urine occurs even when the patient is lying down.

The most frequent cause of the sphincter system becoming weak is the loss of tone of the pelvic floor muscles, often as the result of damage caused by great pressure during childbirth, diminished blood supply to this area due to a hormone deficiency, during climacteric or because of general muscle wasting as one grows older. This is why stress incontinence affects almost exclusively women. When it occurs in men, it is caused in most cases by damage to the sphincter resulting from prostate surgery.