What is stress urinary incontinence?
Your pelvic floor is a hammock of muscle that supports the bladder and closes the urethra. When you cough or jump, those muscles should tighten a fraction of a second before the pressure arrives. In stress incontinence that reflex is weak, slow or poorly coordinated, or the tissue that supports the urethra has been stretched, so a spurt of urine escapes.
The amount can be a few drops or enough to soak through clothing. Many people start planning their day around it: dark clothing, liners, skipping the trampoline park or the running group. Because leaks are so common after having a baby, they are often brushed off as normal. They are common, but they are treatable, and the earlier you start, the simpler treatment usually is.
Common signs and symptoms
- Leaking a small or moderate amount of urine when you cough, sneeze or laugh
- Leaks during running, jumping, skipping, lifting or high-intensity classes
- Leaking when you stand up, bend over or pick up a child
- No warning or urge before the leak happens
- Wearing a liner or pad “just in case” for exercise or a cold
- Leaks that started after pregnancy, childbirth or menopause, or after prostate surgery in men
What causes it?
- Pregnancy and vaginal birth, which stretch the pelvic floor and its supporting tissue
- Menopause, when lower estrogen thins the urethral tissue and weakens support
- Chronic coughing, constipation and straining, which repeatedly load the pelvic floor
- High-impact sport without matching pelvic floor strength and pressure control
- Prostate surgery (radical prostatectomy), which can weaken the urethral sphincter in men
- A pelvic floor that is actually too tight to contract further, so it cannot react to a cough
How pelvic floor physiotherapy helps
Pelvic floor physiotherapy is the recommended first treatment for stress incontinence. Rather than handing you a Kegel leaflet, your physiotherapist checks how your muscles actually contract, relax and time themselves, then builds a program you can do at home and measures your progress.
A treatment plan typically includes:
- An assessment of pelvic floor strength, endurance, coordination and timing, with an internal exam only if you consent
- An individualized pelvic floor muscle training program, progressed as you get stronger
- “The knack”: learning to pre-contract before a cough, sneeze or lift so the leak never starts
- Breathing and pressure management so your abdomen, diaphragm and pelvic floor work together
- A graded return to running, lifting and impact sport instead of avoiding it
- Habits that lower the load on your bladder: constipation, coughs, fluids and toileting patterns
What the research says
The studies below are peer-reviewed and linked to their permanent records so you can read them yourself.
In this Cochrane review of 31 trials, women with stress incontinence who did pelvic floor muscle training were about eight times more likely to report being cured than women who had no treatment, and reported fewer leaks and better quality of life.
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 of Systematic Reviews, 2018. View study
Explains why training works: a stronger, faster pelvic floor lifts the urethra and closes it during a rise in pressure, and a learned pre-contraction (“the knack”) stops leaks before they start.
Bø K. Pelvic floor muscle training is effective in treatment of female stress urinary incontinence, but how does it work?. International Urogynecology Journal, 2004. View study
The UK NICE guideline recommends a supervised pelvic floor muscle training program of at least three months as first-line treatment for stress or mixed urinary incontinence, before medication or surgery.
National Institute for Health and Care Excellence. Urinary incontinence and pelvic organ prolapse in women: management (NG123). NICE guideline, 2019. View study
Treatment at Corelife Wellness in Oakville
Corelife Wellness is a dedicated pelvic health clinic at 3075 Hospital Gate, Unit 312, Oakville, next to Oakville Trafalgar Memorial Hospital. Care starts with a free 15-minute consultation by phone, video or in person, followed by a full assessment with our Registered Physiotherapist. Every pelvis is unique, so your plan is built from that exam rather than a template. No referral is needed, and physiotherapy is often eligible under extended health benefits.
How assessment and treatment work, and how to book, are on our main page: Pelvic floor physiotherapy in Oakville. When hands-on therapy alone is not enough, the Libby Chair (Emsella), a non-invasive pelvic floor stimulation treatment, is available in the same clinic with no new referral.
Helpful reading from our team
When to see a doctor first
Pelvic floor physiotherapy is safe and you do not need a referral, but some symptoms need a medical assessment before or alongside treatment:
- Blood in your urine, or pain and burning when you pee, which can point to infection or another bladder problem
- Leaking that started suddenly alongside back pain, numbness in the saddle area or weakness in your legs
- Being unable to empty your bladder, or a constant dribble
- Leaks with fever, unexplained weight loss or a new lump you can feel
