Fellowship-Trained Urogynecologist
Urogynecology & Reconstructive Pelvic Surgery
Green Bay, Wisconsin
✓ Medically reviewed March 2026
Stress urinary incontinence in women
Stress urinary incontinence (SUI) is one of the most common reasons women come to see me. If you’re leaking urine when you cough, sneeze, laugh, or exercise, you should know that we can treat it.
What is Stress Urinary Incontinence?
Stress urinary incontinence is the involuntary leakage of urine during physical activities that increase abdominal pressure. It can happen during everyday actions like:
- Coughing
- Sneezing
- Laughing
- Exercising
- Lifting heavy objects
Key Point
With SUI, the physical stress or pressure on your bladder causes urine leakage (not emotional stress).
How Common is Stress Urinary Incontinence?
I see women with SUI every week in my clinic. It affects up to 35% of adult women, can happen at any age, and often shows up after pregnancy and childbirth.
One thing I always tell my patients: SUI is common, but it is not a normal part of aging or an inevitable consequence of childbirth. It’s a medical condition, and we have good treatments for it.
Causes and Risk Factors
SUI happens when the pelvic floor muscles and tissues that support the bladder and urethra get weakened or damaged. The most common cause I see is pregnancy and vaginal delivery, which can stretch and injure those muscles. Menopause plays a role too, since lower estrogen levels weaken the pelvic tissues over time.
Carrying extra weight puts more pressure on the bladder and pelvic floor. Chronic coughing from asthma or smoking doesn’t help either, and neither do repetitive high-impact activities. Some women just have weaker connective tissue, so there can be a family component.
Symptoms
The main symptom is urine leakage during activities that put pressure on your abdomen. That might be a few drops when you laugh or sneeze, or a larger amount during exercise or lifting. The thing that separates SUI from other types of incontinence is that you leak without feeling any urge to urinate beforehand.
Diagnosis
When you come in for an evaluation, I’ll start by asking about your symptoms: when they started, what triggers them, how they’re affecting your daily life. Then I’ll do a physical exam to check for prolapse or anything else that might be going on, and a urinalysis to rule out infection.
I often do a bladder stress test, which is exactly what it sounds like: I’ll ask you to cough while I watch for urine loss. In some cases I’ll also recommend urodynamic testing to get a more detailed picture of how your bladder is functioning.
Treatment Options
I walk through all the options with my patients so we can decide together what makes the most sense for their situation.
Conservative Treatments
Pelvic floor exercises (Kegels) are often the first step. We have pelvic floor physical therapists in our office who can work with you directly, and biofeedback can help you learn to identify and control those muscles. Lifestyle changes like weight loss, cutting back on caffeine, and quitting smoking can also help.
Devices and Products
A vaginal pessary is a reusable support device that sits in the vagina and reduces leakage. It works well for women who want relief without surgery. There are also disposable vaginal inserts, which are small tampon-like devices you can use before exercise or other activities. Pads or protective underwear can help manage leaks in the meantime too.
Medical Treatments
Topical estrogen can help strengthen tissue around the urethra and vagina, particularly after menopause. Urethral bulking agents are another option. These are substances injected around the urethra to help it close more effectively.
Surgical Options
Surgery is also very effective. Sling procedures use your own tissue or synthetic material to support the urethra. Colposuspension is another approach that lifts and supports the bladder neck.
What works for one woman may not be the right fit for another, and I spend time going through all of this so we can land on the right plan for you.
Managing SUI Day to Day
A few things can help in the meantime. Going to the bathroom before physical activities reduces the chance of leakage. Cutting back on caffeine and alcohol helps too, since both irritate the bladder. Keep up with your pelvic floor exercises, stay hydrated, and try to limit fluids close to bedtime.
Next Steps
If any of this sounds familiar, come in and talk about it. I have these conversations every day. It helps to keep a symptom diary before your visit so we can get the full picture, but it’s not required. We’ll figure out what’s going on together.
References
- Luber KM. The definition, prevalence, and risk factors for stress urinary incontinence. Rev Urol. 2004;6(Suppl 3):S3-S9. PMID: 16985863
- Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018;10(10):CD005654. doi:10.1002/14651858.CD005654.pub4
- American Urological Association/Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction. Surgical Treatment of Female Stress Urinary Incontinence: AUA/SUFU Guideline. 2017.