Stress Urinary Incontinence: Leaking When You Cough or Laugh

শেষ আপডেট: আগস্ট 15, 2026

• ওয়ার্ডপ্রেস
• লিঙ্কডইন
• মেইল

Stress urinary incontinence (SUI) is leakage that happens when pressure inside the abdomen rises — coughing, laughing, sneezing, exercising, lifting something heavy. It affects around 15% of adult women, and the statistic that matters more is the second one: only about 60% of them ever seek treatment.

That gap is the reason for this article. Women stop running, avoid trampolines with their children, plan outings around toilets and carry spare underwear — all for a condition that is common, well understood and treatable. There is nothing shameful in it, and nothing inevitable about it either.

• ইউরোলজি সেন্টার ব্যাংকক হাসপাতাল থাইল্যান্ড অনলাইনে বুক করুন 02-310-3009 bhquro@bdms.co.th
• সামিটেজ শ্রীরাচা হাসপাতাল চোনবুড়ি 088-022-1445

The 2 major causes of stress urinary incontinence

1. Pelvic floor dysfunction

The pelvic floor muscles are the hammock that keeps the urethra closed when pressure rises. Anything that weakens or damages them can cause SUI:

• স্থূলতা — the pelvic floor carries the weight of everything above it, and excess abdominal weight increases that load year after year.
• Menopause — estrogen maintains the blood supply and lining of the urethra; when it falls, the urethra seals less effectively.
• গর্ভাবস্থা — each pregnancy loads the pelvic floor, and the risk rises with the number of them.
• Vaginal delivery — some pelvic floor trauma is unavoidable as the baby passes through, particularly where there is a perineal tear.
• Chronic cough and constipation — repeated pressure spikes, day after day, wear the pelvic floor down. Both are treatable, which makes them the most modifiable items on this list.

2. Nerve or muscle damage from previous pelvic surgery

Major pelvic surgery can disrupt the continence mechanism directly. In men, radical prostatectomy for prostate cancer is the usual context — worth saying plainly, because SUI is often thought of as a women’s condition and men who develop it afterwards are frequently unprepared for it.

Getting the diagnosis right first

Assessment covers a full history, physical examination and appropriate tests. The important thing it establishes is which kind of incontinence you actually have, because stress incontinence and অসংযম তাড়া are treated completely differently — and many women have both at once.

Where the picture is mixed or the symptoms do not fit neatly, a urodynamic study measures how the bladder and urethra behave during filling and during a rise in pressure, which settles it. Dr. Soarawee performs urodynamic studies at Bangkok Hospital Headquarters.

Treatment, in order

1. Behavioural measures — first line

• Kegel (pelvic floor) exercises — 3 sets of 10 contractions, each held for 10 seconds, three times a day. Two things are worth knowing before you start: improvement takes 6–12 weeks, so early disappointment is normal rather than failure; and a great many women contract the wrong muscles, so having the technique checked by a pelvic floor physiotherapist is time well spent.
• Timed voiding — emptying on a schedule so the bladder is never full when the pressure rises.
• Weight loss and treating a chronic cough or constipation — unglamorous, and they remove the force that is causing the leakage in the first place.
• Pessary — useful where examination shows anatomical prolapse contributing to the problem.

2. Medication — second line

• Duloxetine — increases the closing pressure of the urethral sphincter. Note that it is licensed for stress incontinence in some countries and not others, so availability varies.
• Topical vaginal estrogen — restores the urethral lining after the menopause; the same treatment also reduces recurrent urinary infections in this group.
• Anticholinergics — these do not treat stress incontinence itself. They are used where there is a coexisting overactive bladder component, which is why establishing the type first matters.

3. Surgery — definitive

• ইউরেথ্রাল বাল্কিং এজেন্ট ইনজেকশন — less invasive, suitable for selected patients, with a shorter recovery.
• Mid-urethral sling (MUS) — the gold standard for female SUI, with high long-term success rates.

Surgery is considered once behavioural measures and medication have been given a fair trial, or where the leakage is severe enough that starting there makes more sense. Neither the mid-urethral sling nor urethral bulking agent injection is performed at Bangkok Hospital Headquarters — if your case reaches that point, a referral to a centre that provides them can be arranged. Everything up to that decision, including the assessment, the urodynamic study and the medical treatment, can be done here.

If you are experiencing stress urinary incontinence and would like specialist evaluation, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. পরামর্শ বুক করুন. Appointments at Samitivej Sriracha Hospital can be arranged by calling the Urology department on 088-022-1445.

Frequently Asked Questions About Stress Urinary Incontinence

What causes stress urinary incontinence?

SUI is caused by weakness or damage to the pelvic floor muscles and urethral sphincter, which normally keep the urethra closed during pressure increases. The two major causes are: (1) pelvic floor muscle dysfunction — from obesity, menopause, pregnancy, vaginal delivery trauma, or chronic cough/constipation; and (2) neuromuscular damage from prior pelvic surgery — particularly radical prostatectomy in men or major gynecological procedures in women. Any factor that weakens the continence mechanism allows urine to escape when abdominal pressure rises.

Do Kegel exercises really help stress incontinence?

Yes — Kegel exercises are the most important first-line treatment for SUI. When performed correctly and consistently (3 sets of 10 contractions held for 10 seconds, three times daily), they strengthen the pelvic floor muscles that support the urethra. Many patients with mild to moderate SUI achieve significant improvement or full continence with dedicated Kegel training alone, without needing medications or surgery. Results typically become noticeable after 6–12 weeks of consistent practice. A physiotherapist or pelvic floor specialist can confirm correct technique.

How is stress incontinence told apart from urge incontinence?

Stress incontinence leaks on physical effort — coughing, laughing, lifting — with no warning urge. Urge incontinence leaks after a sudden compelling need to pass urine. The distinction matters because the treatments differ completely, and many women have both, which is called mixed incontinence. Where the history is unclear or symptoms are mixed, a urodynamic study measures bladder and urethral behaviour during filling and straining, and establishes which mechanism is dominant.

When should surgery be considered for stress incontinence?

Surgery is recommended when behavioral therapy and medications have not provided adequate symptom control, or when the SUI is severe enough to significantly affect daily life. The mid-urethral sling (MUS) procedure is the gold standard surgical treatment for female SUI, and urethral bulking agent injection is a less invasive intermediate option. Neither procedure is performed at Bangkok Hospital Headquarters; assessment, urodynamic study and medical treatment are provided here, and a referral to a centre offering surgery can be arranged when it is needed.

দাবি পরিত্যাগ This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for educational purposes only and does not constitute medical advice. No medical advice, diagnosis or prescription is provided through personal messaging channels. Always consult a qualified healthcare professional before starting any medical treatment.