How to Stop Urine Leaking with Coughing
Stress urinary incontinence (SUI) is the involuntary loss of urine that occurs when intra-abdominal pressure increases, such as during coughing, sneezing, laughing, or lifting. It is one of the most common bladder concerns, particularly for people who have had children or experienced shifts in pelvic floor function over time.
The causes of SUI vary and can include pelvic floor muscle weakness or tension, reduced support around the bladder and urethra, and disruptions in the body's overall pressure management system. Because the pelvic floor does not work in isolation, how a person breathes, moves, and carries load can all play a role in whether leakage occurs.
Pelvic floor therapy offers a path toward identifying the specific factors contributing to leakage and addressing them directly. Short-term strategies, support devices, and medical options are also available depending on what is right for the individual.
If you’ve been struggling with bladder leakage with coughing, you aren’t alone! In fact, with pollen season almost always upon us in Atlanta– you’re in good company!
This type of bladder leakage is known as stress urinary incontinence.
Stress urinary incontinence (or SUI) refers to any involuntary urine loss with an increase in intra-abdominal pressure.
This can happen from sneezing, laughing, jumping, lifting, a quick movement, or… you guessed it… coughing!
We know that SUI is very common, especially after having babies! There are several potential causes of this type of leakage.
It can come from:
Loss of support around the bladder and the bladder neck
Decreased fascial support around the urethra
Pelvic floor muscle weakness (specifically at the urethral sphincter)
Pelvic floor muscle tension (typically leading to weakness due to compression around the nerves as well as pressure management issues)
Functional deficits in the pressure management system- the pelvic floor doesn’t work alone. It’s part of a system of structures that help to manage pressure in the abdomen and the pelvis. So, what’s happening in your upper body impacts the lower body. How you move, breathe, and lift, matter too! Read more about all of that here!
Note: leakage is also really common in men after having their prostate removed. If you want to learn more about that, check out this blog with more details!
So, what can you do if you’re coughing and leaking?Let’s dive in!
How do you stop Urine leaking with coughing?
To stop leaking urine, we have both short-term and long-term aids.
Short term aids:
“The Knack” – This was a strategy designed a long time ago, and basically involved pre-activating your pelvic floor muscles before the increase in pressure. Feel that cough coming on, squeeze your pelvic floor muscles BEFORE hand. Simple enough? Definitely– but research also shows that it will stop bladder leakage in over ⅔ of people!
Perineal pressure – Pressure against the perineum can also help! (it’s why you want to cross your legs!!). I use this strategy a lot to help my patients when a GI bug hits– vomitting can cause BIG increases in pressure. A simple rolled towel by the toilet that can be pressed into the perineum often helps a lot!
Long term conservative options:
Pelvic floor therapy – we aim to help our patients identify what is impacting their pressure management system and get to the root of the problem. Sometimes this means targeting optimizing the pelvic floor muscles, and sometimes it means addressing something else in the body or the movement itself! We typically see improvements start happening within the first 3-4 visits.
Support devices – Intravaginal support devices (ie pessaries) can be hugely beneficial when someone is dealing with this type of leakage. There are some options that can be bought over the counter (ie Revive, Uresta), and other options that require a provider to fit. At SPH, our clinicians are trained in pessary fitting so they can help patients find the customized option that works well for them! These support devices help to improve the bladder support and can also compress around the bladder neck/urethra to aid in bladder control.
Long-term Medical Options:
Urethral bulking procedures (ie Bulkamid): Physicians can offer this intervention to improve compression around the urethra. In the case of bulkamid, a water-based hydrogel is injected in the urethral wall to narrow the space, improving control of urine.
Surgical procedures (ie transvaginal slings): Surgeons can offer this intervention to improve support around the urethra and/or the bladder.
** Note: obviously, conservative care is our specialty, but medical and surgical options are often key for the right patient! The right treatment really has to be individualized to the patient, their anatomy, their body! If you need help finding the right medical option for you– reach out! We are fortunate to be connected with the best physicians in metro Atlanta, and happy to help you find the right one to see!
Where to find help for leaking in Atlanta and Marietta
We offer pelvic health physical therapy for leaking at our offices in Marietta and Atlanta. We treat all ages and all genders, and would love to help you.
Feel free to reach out by clicking the button below and requesting an appointment.
Wanna learn more? We have so much educational info available on this topic!