When you strain the abdomen, the pressure on the bladder is increased. Normally the muscle holding the bladder neck is strong and is able to keep the urine in the bladder. If the bladder neck is damaged or weak (typically as a result of the trauma of a vaginal delivery), you may leak urine when you exert yourself.
How does it happen?
Up to 25% of women are affected at sometimes in their lives. Nearly half of all pregnant women complain of urinary incontinence during pregnancy. The hormone Relaxin, which has high levels in pregnancy, softens the ligaments and muscles of the pelvic floor so that the baby can be pushed out easily during childbirth. At the time of menopause there is a reduction in oestrogen, which causes thinning in the membranes of the urethra and vagina, and the urethra becomes drier and less elastic, making it difficult to close completely. The symptoms are usually soreness around the labia and in the vagina and a burning sensation when passing urine.
Prolapse of the womb (‘dropped’ womb) or vagina can occur independently of stress incontinence, and vice versa. This problem is also as a result of the stretching and trauma of childbirth, but typically presents years later around the time of the menopause.