If you accidentally pee or leak urine when you laugh, cough, sneeze, or jump, you have a condition known as stress urinary incontinence (SUI). Stress urinary incontinence is a very common disorder for women and can affect men as well. This leakage is often noticed with exertional activities such as running/jumping or in times when the pressure of your abdomen is increased such as coughing/sneezing which pushes on your bladder. SUI is often under-reported and undertreated due to people being embarrassed to discuss these problems with their healthcare provider, a misunderstanding that urinary leakage is a normal part of aging, and lack of education on available treatments. SUI can lead to decreased quality of life because it can affect many parts of your daily activities. People with SUI may limit their physical or social hobbies causing isolation, see an increase in sexual dysfunction due to fear of leakage during intercourse, notice changes to their mental health such as suffering from anxiety or depression and have an increase in their risk of falls and nursing home admission. Fortunately, there are many treatment options to treat stress incontinence to improve your quality of life.
5 Things To Do If You Pee When You Cough, Sneeze, Laugh, or Jump
1. Visit a Pelvic Floor Physical Therapist
A pelvic floor physical therapist has undergone specialized training to treat disorders of the pelvic floor including stress urinary incontinence. Your pelvic floor muscles (PFM) sit between your hip bones like a hammock and help support the bladder as well as close off the urethra, the tube that allows urine to exit the bladder to the outside of your body. Disorders of the pelvic floor that may contribute to SUI are weakness or tightness of these muscles or poor timing of contractions of these muscles preventing full closure of the urethra when needed. Your PFM are supposed to quickly contract prior to increased abdominal pressure such as coughing or sneezing to prevent leakage. However, for people who have SUI, this reflex may be absent, too slow, or not strong enough. A pelvic floor physical therapist can assess if your pelvic floor muscles need strengthening, relaxation, or improved timing to reduce or eliminate SUI. Your PT can train you in the Knack maneuver which is the purposeful contraction of the pelvic floor muscles prior to stressful events like laughing or jumping to prevent urine leakage. Due to the effectiveness of pelvic floor physical therapy, it is recommended to be the first line of treatment for SUI in women and men.
2. Improve Your Kegels With Vaginal Weights
Having a strong pelvic floor and the ability to sense when you are performing a pelvic floor muscle (Kegel) contraction, are vital for reducing stress urinary incontinence. Using a vaginal weight helps strengthen these muscles by providing resistance to facilitate muscle growth. Most vaginal weights come in sets with progressive resistance to increase your strength over time. Additionally, the presence of a vaginal weight inside your vagina when you learn how to correctly perform a Kegel contraction can help provide feedback for correct muscle activation. A correct Kegel is performed when your pelvic floor muscles draw up and into your body and will be felt, or imagined without a weight, as the vaginal weight rising up. Studies have shown some women perform Kegel contractions incorrectly without training. Incorrect Kegels activate alternative muscles like your inner thigh, gluteal, or abdominal muscles instead of your pelvic floor muscles. If you are utilizing a vaginal weight, too much abdominal activation or failure to activate your pelvic floor muscles may result in the vaginal weight sliding downward or fully falling out indicating that you are not performing a correct Kegel. The presence of the weight allows you to better feel for a correct Kegel to improve your ability to perform a Kegel when needed such as with the Knack maneuver.
More in-depth information on the use of Kegel weights can be found here:
3. Lifestyle Modification
There are several lifestyle modifications that can be changed to decrease the risk of developing or worsening stress urinary incontinence which includes weight loss, stopping smoking, and constipation management. (Al-Shaikh)
4. Being Fitted for a Pessary
A pessary is a medical device that can be inserted into the vagina to support the bladder and urethra to treat SUI. Pessaries come in many sizes and shapes for different purposes to fit your needs including if you are sexually active, need support for pelvic organ prolapse as well as SUI, and severity of your incontinence. A pessary should be fitted by a trained healthcare professional such as a gynecologist, urologist, or primary care physician as fittings often require trial and error to find an appropriately sized and shaped device. Pessaries are considered safe and effective for the treatment of SUI with few side effects.
5. Avoid Bladder Irritants
Avoiding food and drinks that irritate the bladder can help in the prevention of urinary incontinence. Drinks that irritate the bladder include soda, coffee, alcohol, highly citric fruit juices, beverages with artificial sweeteners and carbonated drinks. Foods include tomatoes, chocolate, citrus fruits, and food that utilize artificial flavors and sweeteners.
About The Author
TO A WHOLE
In 2008, Amanda found herself enduring a personal and tragic accident while on a camping trip with her husband and friends. She sustained a dislocation to her coccyx and significant damage to the muscles, tendons and ligaments of her pelvic floor after a 40 foot fall.
“ I hit the water in a seated position and had to be fished out of the river by my husband like a bug out of a pool, I couldn’t sit for several months. ”
Fortunately, Amanda saw a pelvic physical therapist who used a comprehensive evaluation, manual techniques and exercises to completely cure her within six months. She healed without further issues, and went on to deliver two baby boys naturally.
Amanda Olson, DPT, PRPC
References
Al-Shaikh, G., Syed, S., Osman, S., Bogis, A., & Al-Badr, A. (2018). Pessary use in stress urinary incontinence: a review of advantages, complications, patient satisfaction, and quality of life. International journal of women’s health, 10, 195–201. Dovepress
Bø, K. Pelvic floor muscle training is effective in treatment of female stress urinary incontinence, but how does it work?. Int Urogynecol J 15, 76–84 (2004). Springer
Perkins, J. (1998). Vaginal Weights for Assessment and Training of the Pelvic Floor. Journal Of WOCN, 25(4), 206-216.
Bø, K., Hagen, R.H., Kvarstein, B., Jørgensen, J., Larsen, S. and Burgio, K.L. (1990), Pelvic floor muscle exercise for the treatment of female stress urinary incontinence: III. Effects of two different degrees of pelvic floor muscle exercises. Neurourol. Urodyn., 9: 489-502. do Online Library
Subak, L. L., Wing, R., West, D. S., Franklin, F., Vittinghoff, E., Creasman, J. M., Richter, H. E., Myers, D., Burgio, K. L., Gorin, A. A., Macer, J., Kusek, J. W., Grady, D., & PRIDE Investigators (2009). Weight loss to treat urinary incontinence in overweight and obese women. The New England journal of medicine, 360(5), 481–490. Nejm
Glass Clark, Stephanie M. MD; Huang, Qi MS; Sima, Adam P. PhD; Siff, Lauren N. MD Effect of Surgery for Stress Incontinence on Female Sexual Function, Obstetrics & Gynecology: February 2020 – Volume 135 – Issue 2 – p 352-360 doi: 10.1097/AOG.0000000000003648