{"id":2883,"date":"2021-04-16T08:00:00","date_gmt":"2021-04-16T01:00:00","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=2883"},"modified":"2026-08-15T00:21:23","modified_gmt":"2026-08-14T17:21:23","slug":"stress-incontinence-%e1%80%86%e1%80%ae%e1%80%b8%e1%80%9e%e1%80%bd%e1%80%ac%e1%80%b8%e1%80%81%e1%80%bc%e1%80%84%e1%80%ba%e1%80%b8%e1%81%8b","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/my\/2021\/04\/16\/stress-incontinence-urinary\/","title":{"rendered":"\u1016\u102d\u1021\u102c\u1038\u1000\u103c\u1031\u102c\u1004\u1037\u103a \u1006\u102e\u1038\u1019\u1011\u102d\u1014\u103a\u1038\u1014\u102d\u102f\u1004\u103a\u1001\u103c\u1004\u103a\u1038 - \u1001\u103b\u1031\u102c\u1004\u103a\u1038\u1006\u102d\u102f\u1038\u101e\u100a\u1037\u103a\u1021\u1001\u102b \u101e\u102d\u102f\u1037\u1019\u101f\u102f\u1010\u103a \u101b\u101a\u103a\u1019\u1031\u102c\u101e\u100a\u1037\u103a\u1021\u1001\u102b \u1006\u102e\u1038\u1011\u103d\u1000\u103a\u1001\u103c\u1004\u103a\u1038"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-52275889 wp-block-columns-is-layout-flex\" style=\"background-color:#8C8C971A;padding-top:2.5rem;padding-right:2.5rem;padding-bottom:2.5rem;padding-left:2.5rem\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"800\" data-attachment-id=\"7037\" data-permalink=\"https:\/\/drsoaraweeurology.com\/my\/new-photo-2024\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" data-orig-size=\"800,800\" data-comments-opened=\"1\" data-image-title=\"Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=800%2C800&#038;ssl=1\" alt=\"Best Urologist working in Chonburi and Cambodia\" class=\"wp-image-7037\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?w=800&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=300%2C300&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=150%2C150&amp;ssl=1 150w, 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Urologist<\/a><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Bangkok hospital Headquarter, Bangkok<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"tel:+66880221445\" target=\"_blank\" rel=\"noreferrer noopener\">Samitivej Sriracha Hospital \u2014 Urology department: <strong>088-022-1445<\/strong><\/a><\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-outline is-style-outline--1\"><a class=\"wp-block-button__link has-background-background-color has-text-color has-background has-link-color has-small-font-size has-custom-font-size wp-element-button\" href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" style=\"color:#1b4965\" target=\"_blank\" rel=\"noreferrer noopener\">Book a 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.242.005.448.013.618.008.17.02.314.034.43.013.117.03.21.05.282.02.072.042.137.066.197.105.216.28.39.527.518.246.13.57.193.972.193.4 0 .714-.07.94-.21.227-.14.394-.346.503-.617a2.43 2.43 0 0 0 .104-.395c.018-.123.027-.282.027-.477V13.2H2.34c-.04 0-.06-.02-.06-.062v-.5c0-.04.02-.062.06-.062h1.812c.04 0 .062.02.062.06v.5c0 .156-.005.296-.014.422a4.71 4.71 0 0 1-.04.342 1.732 1.732 0 0 1-.064.262c-.13.523-.402.913-.815 1.17-.413.255-.95.382-1.61.382z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/orcid.org\/0009-0004-8387-3559\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"ORCID iD\"\n     aria-label=\"View ORCID Profile\"\n     style=\"text-decoration: none; color: #A6CE39; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M12 0C5.372 0 0 5.372 0 12s5.372 12 12 12 12-5.372 12-12S18.628 0 12 0zM7.369 4.378c.525 0 .947.431.947.947 0 .525-.422.947-.947.947-.525 0-.946-.422-.946-.947 0-.525.421-.947.946-.947zm-.722 3.038h1.444v10.041H6.647V7.416zm3.562 0h3.9c3.712 0 5.344 2.653 5.344 5.025 0 2.578-2.016 5.025-5.325 5.025h-3.919V7.416zm1.444 1.303v7.444h2.297c3.272 0 4.022-2.484 4.022-3.722 0-2.016-1.284-3.722-4.097-3.722h-2.222z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/scholar.google.com\/citations?user=lTgsRMUAAAAJ&#038;hl=en\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"Google Scholar\"\n     aria-label=\"View Google Scholar Profile\"\n     style=\"text-decoration: none; color: #4285F4; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M5.242 13.769L0.5 9.5 12 1l11.5 8.5-4.742 4.269C17.548 11.249 14.978 9.5 12 9.5c-2.977 0-5.548 1.748-6.758 4.269zM12 10a7 7 0 1 0 0 14 7 7 0 0 0 0-14z\"\/>\n    <\/svg>\n  <\/a>\n  \n<\/div>\n\n\n\n<p class=\"has-drop-cap wp-block-paragraph\">Stress urinary incontinence (SUI) is leakage that happens when pressure inside the abdomen rises \u2014 coughing, laughing, sneezing, exercising, lifting something heavy. It affects around <strong>15% of adult women<\/strong>, and the statistic that matters more is the second one: <strong>only about 60% of them ever seek treatment<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That gap is the reason for this article. Women stop running, avoid trampolines with their children, plan outings around toilets and carry spare underwear \u2014 all for a condition that is common, well understood and treatable. There is nothing shameful in it, and nothing inevitable about it either.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Urology center Bangkok hospital Thailand\u00a0<a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Booking online<\/a>\u00a0<a href=\"tel:02-310-3009\">02-310-3009<\/a>\u00a0<a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a><\/li>\n\n\n\n<li>Samitivej Sriracha hospital Chonburi&nbsp;<a href=\"tel:088-022-1445\">088-022-1445<\/a><\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"450\" data-attachment-id=\"2890\" data-permalink=\"https:\/\/drsoaraweeurology.com\/my\/2021\/04\/16\/stress-incontinence-urinary\/cough\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Cough.jpg?fit=1200%2C675&amp;ssl=1\" data-orig-size=\"1200,675\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;6.3&quot;,&quot;camera&quot;:&quot;Canon EOS 5D Mark III&quot;,&quot;created_timestamp&quot;:&quot;1582306103&quot;,&quot;copyright&quot;:&quot;Freepik.com&quot;,&quot;focal_length&quot;:&quot;50&quot;,&quot;iso&quot;:&quot;100&quot;,&quot;shutter_speed&quot;:&quot;0.00625&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Urine leakage during coughing is a classical sign of stress incontience.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Urine leakage during coughing is a classical sign of stress incontience.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Cough.jpg?fit=800%2C450&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Cough.jpg?resize=800%2C450&#038;ssl=1\" alt=\"A woman coughing, the classic trigger for stress urinary incontinence leakage\" class=\"wp-image-2890\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Cough.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Cough.jpg?resize=300%2C169&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Cough.jpg?resize=1024%2C576&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Cough.jpg?resize=768%2C432&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Cough.jpg?resize=16%2C9&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Leaking while coughing is the classic presentation of stress urinary incontinence.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">The 2 major causes of <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK539769\/\">stress urinary incontinence<\/a><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">1. Pelvic floor dysfunction<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The pelvic floor muscles are the hammock that keeps the urethra closed when pressure rises. Anything that weakens or damages them can cause SUI:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Obesity<\/strong> \u2014 the pelvic floor carries the weight of everything above it, and excess abdominal weight increases that load year after year.<\/li>\n\n\n\n<li><strong>Menopause<\/strong> \u2014 estrogen maintains the blood supply and lining of the urethra; when it falls, the urethra seals less effectively.<\/li>\n\n\n\n<li><strong>Pregnancy<\/strong> \u2014 each pregnancy loads the pelvic floor, and the risk rises with the number of them.<\/li>\n\n\n\n<li><strong>Vaginal delivery<\/strong> \u2014 some pelvic floor trauma is unavoidable as the baby passes through, particularly where there is a perineal tear.<\/li>\n\n\n\n<li><strong>Chronic cough and constipation<\/strong> \u2014 repeated pressure spikes, day after day, wear the pelvic floor down. Both are treatable, which makes them the most modifiable items on this list.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"2894\" data-permalink=\"https:\/\/drsoaraweeurology.com\/my\/2021\/04\/16\/stress-incontinence-urinary\/obese-boy-who-is-overweight-on-a-pink-background\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Obesity.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;8&quot;,&quot;camera&quot;:&quot;Canon EOS 5D Mark III&quot;,&quot;caption&quot;:&quot;Obese boy who is overweight on a pink background.&quot;,&quot;created_timestamp&quot;:&quot;1554759101&quot;,&quot;focal_length&quot;:&quot;50&quot;,&quot;iso&quot;:&quot;100&quot;,&quot;shutter_speed&quot;:&quot;0.01&quot;,&quot;title&quot;:&quot;Obese boy who is overweight on a pink background.&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"More in abdominal fat will possibly lead to\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;More in abdominal fat will possibly lead to&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Obesity.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Obesity.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Excess abdominal weight, which increases the load carried by the pelvic floor\" class=\"wp-image-2894\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Obesity.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Obesity.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Obesity.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Obesity.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Obesity.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Excess abdominal weight increases pelvic floor load and accelerates dysfunction.<\/figcaption><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">2. Nerve or muscle damage from previous pelvic surgery<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Major pelvic surgery can disrupt the continence mechanism directly. In men, <a href=\"https:\/\/drsoaraweeurology.com\/services\/robotic-prostatectomy\/\">radical prostatectomy for prostate cancer<\/a> is the usual context \u2014 worth saying plainly, because SUI is often thought of as a women&#8217;s condition and men who develop it afterwards are frequently unprepared for it.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"2892\" data-permalink=\"https:\/\/drsoaraweeurology.com\/my\/2021\/04\/16\/stress-incontinence-urinary\/rear-view-of-surgeons-preparing-for-operation-in-operation-room\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Major-operation.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;caption&quot;:&quot;rear view of surgeons preparing for operation in operation room at the hospital&quot;,&quot;created_timestamp&quot;:&quot;1470109069&quot;,&quot;title&quot;:&quot;Rear view of surgeons preparing for operation in operation room&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Major intraabdominal surgeries can be resulted in postoperative SUI.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Major intraabdominal surgeries can be resulted in postoperative SUI.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Major-operation.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Major-operation.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Pelvic surgery, which can disrupt the continence mechanism and cause stress incontinence\" class=\"wp-image-2892\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Major-operation.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Major-operation.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Major-operation.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Major-operation.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Major-operation.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Major pelvic surgery such as radical prostatectomy can cause post-operative stress incontinence.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Getting the diagnosis right first<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Assessment covers a full history, physical examination and appropriate tests. The important thing it establishes is <strong>which kind of incontinence you actually have<\/strong>, because stress incontinence and <a href=\"https:\/\/drsoaraweeurology.com\/2020\/06\/12\/overactive-bladder-syndrome\/\">urge incontinence<\/a> are treated completely differently \u2014 and many women have both at once.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Where the picture is mixed or the symptoms do not fit neatly, a <strong>urodynamic study<\/strong> measures how the bladder and urethra behave during filling and during a rise in pressure, which settles it. <strong>Dr. Soarawee performs urodynamic studies at Bangkok Hospital Headquarters.<\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Treatment, in order<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">1. Behavioural measures \u2014 first line<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Kegel (pelvic floor) exercises<\/strong> \u2014 3 sets of 10 contractions, each held for 10 seconds, three times a day. Two things are worth knowing before you start: <strong>improvement takes 6\u201312 weeks<\/strong>, 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.<\/li>\n\n\n\n<li><strong>Timed voiding<\/strong> \u2014 emptying on a schedule so the bladder is never full when the pressure rises.<\/li>\n\n\n\n<li><strong>Weight loss and treating a chronic cough or constipation<\/strong> \u2014 unglamorous, and they remove the force that is causing the leakage in the first place.<\/li>\n\n\n\n<li><strong>Pessary<\/strong> \u2014 useful where examination shows anatomical prolapse contributing to the problem.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"2895\" data-permalink=\"https:\/\/drsoaraweeurology.com\/my\/2021\/04\/16\/stress-incontinence-urinary\/happy-woman-doing-pelvic-muscle-exercise-on-mat\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Pelvic-floor-exercise.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;1.4&quot;,&quot;credit&quot;:&quot;Alexey Tulenkov&quot;,&quot;camera&quot;:&quot;Canon EOS 5D Mark II&quot;,&quot;caption&quot;:&quot;Portrait of happy young Caucasian woman wearing sportswear doing pelvic muscle exercise lying on mat and smiling in gym&quot;,&quot;created_timestamp&quot;:&quot;1402250947&quot;,&quot;focal_length&quot;:&quot;50&quot;,&quot;iso&quot;:&quot;400&quot;,&quot;shutter_speed&quot;:&quot;0.005&quot;,&quot;title&quot;:&quot;Happy woman doing pelvic muscle exercise on mat&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Pelvic floor exercise can improve SUI symptom.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Pelvic floor exercise can improve SUI symptom.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Pelvic-floor-exercise.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Pelvic-floor-exercise.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Pelvic floor exercise, the proven first-line treatment for stress urinary incontinence\" class=\"wp-image-2895\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Pelvic-floor-exercise.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Pelvic-floor-exercise.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Pelvic-floor-exercise.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Pelvic-floor-exercise.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/04\/Pelvic-floor-exercise.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Pelvic floor exercises done correctly and consistently are the proven first-line treatment.<\/figcaption><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">2. Medication \u2014 second line<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Duloxetine<\/strong> \u2014 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.<\/li>\n\n\n\n<li><strong>Topical vaginal estrogen<\/strong> \u2014 restores the urethral lining after the menopause; the same treatment also reduces recurrent urinary infections in this group.<\/li>\n\n\n\n<li><strong>Anticholinergics<\/strong> \u2014 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.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">3. Surgery \u2014 definitive<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Urethral bulking agent injection<\/strong> \u2014 less invasive, suitable for selected patients, with a shorter recovery.<\/li>\n\n\n\n<li><strong>Mid-urethral sling (MUS)<\/strong> \u2014 the gold standard for female SUI, with high long-term success rates.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">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. <strong>Neither the mid-urethral sling nor urethral bulking agent injection is performed at Bangkok Hospital Headquarters<\/strong> \u2014 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.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you are experiencing stress urinary incontinence and would like specialist evaluation, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\">Book a Consultation<\/a>. Appointments at Samitivej Sriracha Hospital can be arranged by calling the Urology department on <a href=\"tel:0880221445\">088-022-1445<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions About Stress Urinary Incontinence<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">What causes stress urinary incontinence?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">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 \u2014 from obesity, menopause, pregnancy, vaginal delivery trauma, or chronic cough\/constipation; and (2) neuromuscular damage from prior pelvic surgery \u2014 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.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Do Kegel exercises really help stress incontinence?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Yes \u2014 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\u201312 weeks of consistent practice. A physiotherapist or pelvic floor specialist can confirm correct technique.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">How is stress incontinence told apart from urge incontinence?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Stress incontinence leaks on physical effort \u2014 coughing, laughing, lifting \u2014 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.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">When should surgery be considered for stress incontinence?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">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.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disclaimer:<\/strong> 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.<\/p>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"MedicalWebPage\",\n      \"headline\": \"Stress Urinary Incontinence: Leaking When You Cough or Laugh\",\n      \"description\": \"Why stress urinary incontinence happens, the two major causes, how urodynamic study separates it from urge incontinence, and the treatment ladder from pelvic floor exercises through medication to the mid-urethral sling.\",\n      \"datePublished\": \"2021-04-16\",\n      \"dateModified\": \"2026-08-12\",\n      \"inLanguage\": \"en\",\n      \"author\": {\n        \"@type\": \"Physician\",\n        \"name\": \"Dr. Soarawee Weerasopone\",\n        \"medicalSpecialty\": \"Urology\",\n        \"url\": \"https:\/\/drsoaraweeurology.com\/\"\n      },\n      \"reviewedBy\": {\n        \"@type\": \"Physician\",\n        \"name\": \"Dr. Soarawee Weerasopone\",\n        \"medicalSpecialty\": \"Urology\"\n      },\n      \"about\": {\n        \"@type\": \"MedicalCondition\",\n        \"name\": \"Stress Urinary Incontinence\",\n        \"alternateName\": \"SUI\"\n      }\n    },\n    {\n      \"@type\": \"FAQPage\",\n      \"mainEntity\": [\n        {\n          \"@type\": \"Question\",\n          \"name\": \"What causes stress urinary incontinence?\",\n          \"acceptedAnswer\": {\n            \"@type\": \"Answer\",\n            \"text\": \"SUI has 2 major causes: (1) Pelvic floor dysfunction from obesity, menopause and loss of estrogen, pregnancy, vaginal delivery trauma, or chronic cough and constipation. 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Many mild to moderate cases improve or resolve without surgery, and a pelvic floor physiotherapist can confirm the technique is correct.\"\n          }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"How is stress incontinence told apart from urge incontinence?\",\n          \"acceptedAnswer\": {\n            \"@type\": \"Answer\",\n            \"text\": \"Stress incontinence leaks on physical effort such as coughing, laughing or lifting, with no warning urge. Urge incontinence leaks after a sudden compelling need to pass urine. The treatments differ completely and many women have both, called mixed incontinence. A urodynamic study measures bladder and urethral behaviour during filling and straining and establishes which mechanism is dominant.\"\n          }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"When should surgery be considered for stress incontinence?\",\n          \"acceptedAnswer\": {\n            \"@type\": \"Answer\",\n            \"text\": \"When behavioural therapy and medication are inadequate, or the leakage severely affects daily life. The mid-urethral sling is the gold standard for female SUI and urethral bulking agent injection is a less invasive intermediate option. Neither is performed at Bangkok Hospital Headquarters; assessment, urodynamic study and medical treatment are provided there, with referral arranged for surgery when needed.\"\n          }\n        }\n      ]\n    }\n  ]\n}\n<\/script>\n","protected":false},"excerpt":{"rendered":"<p>\u1001\u103b\u1031\u102c\u1004\u103a\u1038\u1006\u102d\u102f\u1038\u1001\u103c\u1004\u103a\u1038\u104a \u101b\u101a\u103a\u1019\u1031\u102c\u1001\u103c\u1004\u103a\u1038 \u101e\u102d\u102f\u1037\u1019\u101f\u102f\u1010\u103a \u1021\u101b\u102c\u101d\u1010\u1039\u1011\u102f\u1010\u1005\u103a\u1001\u102f\u1001\u102f\u1000\u102d\u102f \u1019\u1010\u1004\u103a\u1001\u103c\u1004\u103a\u1038\u1010\u102d\u102f\u1037\u1015\u103c\u102f\u101c\u102f\u1015\u103a\u101e\u100a\u1037\u103a\u1021\u1001\u102b \u1006\u102e\u1038\u1005\u1025\u103a\u1038\u1011\u103d\u1000\u103a\u1001\u103c\u1004\u103a\u1038\u101e\u100a\u103a \u1021\u1016\u103c\u1005\u103a\u1019\u103b\u102c\u1038\u1015\u103c\u102e\u1038 \u1000\u102f\u101e\u1015\u103b\u1031\u102c\u1000\u103a\u1000\u1004\u103a\u1038\u1014\u102d\u102f\u1004\u103a\u101e\u1031\u102c \u1021\u1001\u103c\u1031\u1021\u1014\u1031\u1010\u1005\u103a\u1001\u102f\u1016\u103c\u1005\u103a\u1000\u102c \u1011\u102d\u1001\u102d\u102f\u1000\u103a\u1001\u1036\u1005\u102c\u1038\u101b\u101e\u1031\u102c \u1021\u1019\u103b\u102d\u102f\u1038\u101e\u1019\u102e\u1038\u1019\u103b\u102c\u1038\u104f 40 % \u1019\u103e\u102c \u104e\u1004\u103a\u1038\u1010\u102d\u102f\u1037\u104f \u1006\u101b\u102c\u101d\u1014\u103a\u1021\u102c\u1038 \u101c\u102f\u1036\u1038\u101d\u1015\u103c\u1031\u102c\u1015\u103c\u101c\u1031\u1037\u1019\u101b\u103e\u102d\u1000\u103c\u1015\u102b\u104b \u1018\u1014\u103a\u1000\u1031\u102c\u1000\u103a\u1006\u1031\u1038\u101b\u102f\u1036\u1000\u103c\u102e\u1038\u1019\u103e \u1006\u102e\u1038\u101c\u1019\u103a\u1038\u1000\u103c\u1031\u102c\u1004\u103a\u1038\u1014\u103e\u1004\u1037\u103a \u1000\u103b\u1031\u102c\u1000\u103a\u1000\u1015\u103a\u1006\u102d\u102f\u1004\u103a\u101b\u102c \u1021\u1011\u1030\u1038\u1000\u102f\u1006\u101b\u102c\u101d\u1014\u103a\u1000\u103c\u102e\u1038 \u1012\u1031\u102b\u1000\u103a\u1010\u102c \u1006\u102d\u102f\u101b\u102c\u101d\u102e \u101d\u102e\u101b\u102c\u1006\u102d\u102f\u1015\u102d\u102f\u1014\u1031\u1000 \u104e\u1004\u103a\u1038\u1016\u103c\u1005\u103a\u1015\u103d\u102c\u1038\u101b\u101e\u100a\u1037\u103a \u1021\u1000\u103c\u1031\u102c\u1004\u103a\u1038\u101b\u1004\u103a\u1038\u1019\u103b\u102c\u1038\u1014\u103e\u1004\u1037\u103a \u1000\u102e\u0e40\u0e01\u101a\u103a (Kegels) \u101c\u1031\u1037\u1000\u103b\u1004\u1037\u103a\u1001\u1014\u103a\u1038\u1019\u103e\u101e\u100a\u103a \u1001\u103d\u1032\u1005\u102d\u1010\u103a\u1000\u102f\u101e\u1019\u103e\u102f\u1021\u1011\u102d \u1000\u102f\u101e\u101b\u1031\u1038\u1021\u1006\u1004\u1037\u103a\u1006\u1004\u1037\u103a\u1000\u102d\u102f \u101b\u103e\u1004\u103a\u1038\u1015\u103c\u1011\u102c\u1038\u1015\u102b\u101e\u100a\u103a\u104b.<\/p>","protected":false},"author":185281453,"featured_media":10100,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"Stress urinary incontinence: why leakage happens on coughing, laughing or lifting, the two major causes, how urodynamics separates it from urge incontinence, and treatment from Kegel exercises to the mid-urethral sling. 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