Many of us know the feeling: laugh at a joke, sneeze or cough and suffer an embarrassing leak of urine.
This condition, known as stress urinary incontinence, affects twice as many women as men.1 Urine leaks happen due to a loss of control during an activity—causing urine to be released because of increased pressure on the bladder. As a result, it often happens when a woman coughs, sneezes, or laughs, or during physical activity.2
You may have heard that one way to treat—or even prevent—stress urinary incontinence is by doing pelvic floor exercises, also known as Kegels. What about other treatment options? What are inserts for stress urinary incontinence? Let’s explore treatments for this common condition.
The Causes of SUI
Stress urinary incontinence, or SUI as it is often called, is a condition that impacts up to 1 in 3 adult women at some point in their lives. It’s the most common type of female incontinence.3 The other types of urinary incontinence are urgency incontinence and overactive bladder, which is when your bladder muscle contracts and creates a sudden urge to urinate before you can get to the bathroom.4
Women have a number of life events that can make incontinence more likely, such as pregnancy, childbirth, and menopause. It’s important to know, however, that it is not a normal part of aging, and it can be treated.1
In fact, the numbers may even be higher, as many women with incontinence often suffer in silence. Researchers believe SUI is under-reported and underdiagnosed. It impacts the work and social life of many women, as they experience fear, shame, and avoidance of social activities,5 worried about being too far from a bathroom, or suffering an embarrassing leak while out in public.
Stress incontinence causes you to leak urine when you cough or sneeze, laugh, exercise, lift something heavy, have sex, or even bend over. It may not happen every time, but any activity that puts pressure on your bladder can make involuntary urine loss more likely, particularly when your bladder is full.4
The main cause of stress urinary incontinence is a weakening of the pelvic floor. This is an important hammock-like structure of muscles and other tissues that support the pelvic organs, and also control the release of urine.4
As your bladder fills with urine, it expands. The valve-like muscles in the tube that carries urine out of your body, known as the urethra, stays closed when the bladder expands. But when the pelvic floor muscles weaken, anything that puts pressure on them can put pressure on the bladder and cause you to leak urine.4
Here are the risk factors that may lead to weakened muscles and in turn stress urinary incontinence in women:6
- Pregnancy and childbirth, particularly vaginal birth.
- Menopause.
- Nerve injuries to the pelvis or lower back.
- Obesity.
- Pelvic surgery, such as a hysterectomy.
- Chronic coughing.
- Diabetes.
- Uterine prolapse.
It also seems that older women are more prone to SUI—whether or not they have had children—as the simple act of aging causes the muscles to weaken.3 However, incontinence is not an inevitable part of aging, although many women may believe this and as a result don’t seek treatment.7 It can be treated.
Treatments for Stress Urinary Incontinence
Depending on a woman’s symptoms, age, preferences, and lifestyle habits, among other factors, there are different treatment options, and some work better than others for different people.
Here are some treatment plans:
1. Possible lifestyle changes: this can include bladder training, or urinating on a fixed schedule; losing weight—as little as 10-15 pounds can help reduce leaking by half or more; diet changes to ease constipation; and quitting smoking, which can make a significant difference in SUI symptoms, such as by reducing a chronic cough.3
2. Pelvic floor therapy: performing exercises that will strengthen the pelvic floor muscles. For instance, a pelvic floor physical therapist can teach you how to properly perform exercises called Kegels, which improve the strength of those important muscles. Research shows that pelvic floor exercises help keep pelvic floor muscles “fit,” and can be performed as a preventive measure, or as treatment for women already suffering with stress urinary incontinence.
There are also products available to help with that therapy. The INNOVO Urinary Incontinence Kit—cleared by the FDA—is a pair of “smart shorts” designed to strengthen your pelvic floor muscles from the inside out. Using the kit, you perform 180 perfect Kegels in 30 minutes. A clinical study guided by the FDA had amazing results: 87% of women were defined as dry after just 12 weeks, and 90% of users would recommend the therapy to others. Subscribe to the INNOVO newsletter to receive a $20 discount code for your purchase!
3. Surgical interventions: there are options to improve closure of the sphincter or support the bladder neck. These include the most common, the sling procedure, in which a surgeon uses mesh to create a sling or hammock that supports the urethra. A second option is known as “retropubic colposuspension,” in which tissues near the bladder neck are attached to ligaments along the pubic bone. Finally, bulking agents can be injected into tissues around the upper portion of the urethra to improve its ability to close.8
Another treatment option involves inserts for stress urinary incontinence.
What Are Inserts for Stress Urinary Incontinence?
Non-surgical treatment options also exist for stress urinary incontinence, which involve several types of inserts:
1. Pessary: An incontinence pessary is a silicone or rubber device that is placed inside the vagina. It’s designed to support the urethra and bladder wall, increase urethral length, and provide gentle compression of the urethra. Also called a vaginal insert, these create a structural arrangement that can reduce and often prevent urine leakage when pressure is placed on the abdomen and bladder, like when you cough. There are different types of pessaries available, and while some are designed for pelvic organ prolapse, some have been designed specifically to treat SUI.9
2. Urethral inserts and seal pads: the inserts are small plugs inserted into the urethra to prevent leakage, and removed prior to urination. The seal pads are adhesive foam pads placed over the urethral opening. This creates a seal and prevents the leakage of urine, and is then removed before urination and replaced with a new one afterwards. The pad can be worn during exercise or physical activity.10
3. Bladder neck support devices: these are flexible rings with two ridges, also inserted into the vagina. The ridges press against the vaginal walls and support the urethra. By lifting the bladder neck, this type of device provides bladder control in women suffering from stress incontinence. It needs to be sized to fit, and must be removed and cleaned after urination.10
There are numerous types of these devices, marketed under different names, that can be purchased over the counter to reduce stress urinary incontinence. Different women may find some to be more effective than others. Some are helpful for occasional continence relief during physical activities, for instance.
Intravaginal bladder support includes a simple surgical foam tampon-shaped cylinder with withdrawal strings, and others are built with an applicator similar to a tampon. Some women have even found a tampon can help.11
It’s a good idea to get advice from your doctor about using inserts for stress urinary incontinence. An internal device can cause discomfort or irritation, and may have time limits for use. Some women also find that inserts reduce their incontinence, but do not prevent leakage completely.11
Don’t Suffer In Silence
Stress urinary incontinence can negatively impact your life, so don’t hide your symptoms from your physician. There are treatment options available, including minimally invasive inserts that can relieve leaks. Use our Physician Finder to find a doctor near you with expertise in women’s health, who can diagnose your incontinence and set you on a treatment path.
