Peeing while sneezing or coughing? Here’s why!

Verified by Dr. Vaishali Sakpal Rane (MBBS, DGO Obstetrics and Gynaecology, DNB Obstetrics and Gynaecology)

If you are uncontrollably peeing while sneezing or coughing then you may be suffering from a condition called stress incontinence. Incontinence is the involuntary loss of urine.

It is of 2 types: 

1. Stress incontinence 
2. Urge incontinence.

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Stress incontinence is caused by physical stress or physical pressure intra abdominally on your bladder and not by any emotional stress whereas urge incontinence is sudden uncontrollable desire to pass urine and often the urine is leaked in pants before the person reaches the bathroom.

The causes of these 2 conditions are different and hence the treatment. However some patients may have both types of incontinence, it is then called mixed incontinence.

Why does stress incontinence occur?

Normally the urinary bladder and urethra i.e the tubelike structure that lets urine pass from the bladder to outside, are supported by a group of muscles in the pelvic floor . The urethral opening is guarded by special smooth muscles called sphincter muscles. 

Normally whenever intra abdominal pressure increases like when you sneeze, cough, laugh loudly, bend over these muscle contracts, close the urethral opening and prevent the peak of urine.However when pelvic floor muscle and sphincter get weakened even a slight pressure on the bladder causes them to relax causing the urethra to open and let the urine flow out.

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Reasons for weakening of pelvic muscles

• Pregnancy and childbirth - It is the most common cause for SUI in women. During vaginal delivery especially the instrumental one using forceps causes injury to the pelvic muscles and nerves . This causes weakening of the muscles over a period of time. Some females may experience leaks immediately after delivery.
• Postmenopausal women - The hormone estrogen is vital to keep pelvic muscle and mucosa in healthy state. Low oestrogen levels further weaken the muscles and tissues of the pelvis making them more prone for developing incontinence.
• Chronic constipation - Constant pressure on the pelvis weakens the pelvic muscles and tissues.
• Chronic cough - conditions like smoking or asthma can cause chronic cough and can eventually lead to SUI
• Spinal cord injury - Injury to spinal cord can damage the nerves of pelvic muscles making them weak
• Obesity- excess weight puts strain on the pelvis which can cause muscles weakening 
• Hysterectomy - surgical removal of uterus and ovaries can cause weaken the supporting muscles

The incidence of SUI is more common in women than men. 1 out of 3 women will experience a leak once in their lifetime. This might become an embarrassing situation for many ladies experiencing it. Many do not come out and seek help because they think it is normal with the ageing process. SUI is not normal . There are several treatment modalities by which it can be cured.There are surgical and non surgical ways to treat incontinence. There’s no need to stay away from social activities to avoid embarrassment. Talk to a health care provider to know about the treatment options available.