Stress urinary incontinence: causes and solutions

Stress urinary incontinence affects nearly three million women in France and remains one of the most common types of bladder leakage. Though it’s more frequent among women over 45, it can affect adults of all ages. These leaks occur during physical efforts - laughing, sneezing, coughing or exercising - and are especially prevalent after the age of 65, when the pelvic muscles and bladder support naturally weaken.

What causes these leaks?

Pressure on the bladder

When pressure in the bladder increases during a movement or effort, it can exceed the sphincter’s ability to hold urine, leading to leakage. Additionally, an overly mobile cervix may worsen the condition. That’s why this issue is often managed by both urology and gynecology specialists.

Common risk factors

Pregnancy is the leading cause of incontinence in women. Later in life, menopause brings hormonal changes that weaken the tissues and mucosa around the bladder. Other contributing factors include recurring urinary tract infections, chronic constipation, and a history of pelvic surgeries, which may impact pelvic floor muscles.

Breaking the silence

Many women don’t discuss their symptoms, even with their doctor, and rely instead on menstrual pads that aren’t designed for urinary incontinence. This silence can lead to shame, anxiety and even depression. Opening up about this issue is the first step toward better care. Healthcare providers are encouraged to address the topic proactively - simple questionnaires can help identify the type of incontinence and guide the right treatment.

How is stress incontinence treated?

There are several ways to manage stress urinary incontinence. In most cases, lifestyle adjustments bring noticeable improvements. Surgery is usually considered only after other options have failed.

Adapting daily habits

Losing weight, adopting a regular meal routine, staying active and managing constipation can all help reduce leakage episodes.

Pelvic floor muscle training

Strengthening the pelvic floor is essential. Several techniques can support this goal:

• Biofeedback: helps you become aware of and control pelvic muscles more effectively.
• Electrostimulation: uses gentle electrical impulses to activate the nerves controlling the bladder and pelvic floor.
• Targeted muscle exercises: should be practiced regularly to improve strength.
• Behavioral therapy: teaches strategies to delay urination and manage bladder urges.

Medical and surgical options

In some cases, hormone therapy may be recommended. For more severe forms of incontinence, surgical solutions exist. Minimally invasive procedures, such as sling placement under the urethra, offer a high success rate - up to 90% - with reduced recovery time.