Stress Urinary Incontinence: How to Treat It
Stress urinary incontinence (SUI) is one of the most common forms of female incontinence, particularly after the age of 40. It primarily affects adult and postmenopausal women. Often overlooked or left unspoken due to embarrassment, this condition can significantly impact quality of life, affecting social interactions, work, emotional well-being, and self-esteem.
So, what exactly is stress urinary incontinence? What causes it, what are the symptoms, and, most importantly, what are the most effective, non-invasive treatment options?
Let’s explore the answers in this evidence-based guide, filled with practical and proven solutions.
What Is Stress Urinary Incontinence?
Stress urinary incontinence (SUI) is the involuntary loss of urine triggered by even mild physical exertion, such as:
- Coughing or sneezing
- Laughing
- Lifting heavy objects
- Exercising
- Climbing stairs or running
What causes this condition? SUI is mainly the result of weakened or damaged support structures around the urethra. This can involve:
- The pelvic floor muscles (e.g., pubococcygeus, iliococcygeus)
- Connective tissue that anchors the urethra and bladder trigone
- The external urethral sphincter, which helps maintain continence under strain
When these structures lose strength or elasticity, they can’t effectively counteract increases in abdominal pressure. As a result, when bladder pressure exceeds the closing pressure of the urethra, urine leakage occurs.
Causes of Stress Urinary Incontinence
Among the most frequent causes, we find:
- Pregnancy and vaginal childbirth – Mechanical and hormonal changes during pregnancy and delivery can stretch and weaken the perineal structures, causing damage to the levator ani muscle or denervation of the pelvic floor (as shown in post-partum electromyographic studies).
- Menopause – The decline in estrogen levels reduces blood flow and weakens the urogenital mucosa and supporting connective A decrease in type I collagen and an increase in type III collagen, less resistant to tension, are also observed.
- Aging – The natural loss of skeletal muscle mass (sarcopenia) and pelvic floor muscle fibers reduces the body’s ability to respond effectively to physical
- Intense physical activity – High-impact sports can cause repeated increases in intra-abdominal pressure, leading over time to functional microtraumas, especially if the pelvic floor is already weakened.
- Pelvic surgery – Procedures such as hysterectomy or colposuspension may impair pelvic nerve function or alter the positioning of the urethra, negatively affecting continence mechanisms.
What Are the Symptoms of Stress Incontinence?
The main symptom is involuntary urine leakage during physical activities. The amount of leakage can range from a few drops to more substantial loss, depending on the severity of the condition.
Often, the issue begins with leakage only during intense exertion, such as during sports. However, over time, it may worsen and occur even during everyday activities.
When Is Urinary Incontinence Considered Severe?
Incontinence is classified as mild, moderate, or severe based on the frequency and volume of leakage:
- Mild: occasional leakage (e.g., during a sneeze).
- Moderate: frequent leakage (multiple times per day).
- Severe: heavy leakage requiring constant use of pads or protective.
According to a study published in Neurourology and Urodynamics, urinary incontinence affects 45% of women over the age of 40, with the highest prevalence between ages 50 and 60.
Stress Incontinence: Treatment Options
The good news is that there are a variety of treatment approaches available, ranging from conservative to more advanced solutions.
1. Pelvic Floor Exercises (Kegel Exercises)
The first-line conservative treatment involves Kegel exercises, designed to strengthen the striated muscles of the pelvic floor.
A review published in The Cochrane Library (Dumoulin et al., 2018) showed that pelvic muscle training significantly improves continence in women with stress urinary incontinence, with improvement rates reaching up to 70% after three months of guided exercises.
2. Pelvic physiotherapy
This includes:
- Manual techniques to relax or activate specific muscle groups
- Biofeedback, which provides real-time visualization of muscle activity
- Electro-stimulation to engage underactive muscle fibers
3. Medical devices and vaginal supports
Pessaries and mechanical inserts offer physical support to the urethra and are recommended for women who prefer to avoid or cannot undergo drug or surgical treatments.
4. Topical hyaluronic acid treatments
Among the most promising options for treating stress urinary incontinence, particularly in menopausal or postpartum women, are products containing hyaluronic acid.
The Role of Hyaluronic Acid in Tissue Firmness
Hyaluronic acid is a naturally occurring molecule in connective tissues, renowned for its deep moisturizing properties, ability to stimulate cellular regeneration, and capacity to restore tissue elasticity.
In gynecology, numerous studies, including one published in Climacteric, demonstrate that topical hyaluronic acid treatments:
- Enhance hydration of the vaginal mucosa
- Promote regeneration of the uro-genital epithelium
- Alleviate symptoms linked to vulvovaginitis, dryness, and vaginal atrophy
- Support functional recovery of the pelvic floor
A healthy, well-hydrated mucosa plays a crucial role in restoring the tone of the urethro-vaginal tissues, thereby improving the strength of the sphincter mechanism.
Osidra: Sublingual Hyaluronic Acid with Systemic Effects
Among the most advanced solutions for restoring the tone and integrity of vaginal mucosa—often compromised by dryness, postmenopausal atrophy, or stress urinary incontinence—is Osidra, a therapeutic system based on highly concentrated, hydrolyzed hyaluronic acid designed for sublingual administration.
Unlike conventional oral supplements, Osidra employs a molecular hydrolysis process that breaks hyaluronic acid into short-chain fragments. Coupled with a patented sublingual delivery method, this ensures rapid and complete absorption (100% bioavailability), bypassing the intestinal barrier that often reduces the effectiveness of oral treatments.
Physiologically, low molecular weight hyaluronic acid penetrates deeply into tissues, activating fibroblasts and encouraging cellular regeneration, while the high molecular weight form provides a protective, hydrating barrier by attracting water and maintaining tissue elasticity and firmness. This dual action is especially beneficial for the vaginal mucosa, which is key in supporting urethral function.
Clinical studies show that vaginal mucosa deterioration and loss of perineal tissue tone are significant risk factors for stress urinary incontinence, a condition affecting roughly 15–30% of women over 40, with peaks during menopause and postpartum. In these cases, bioactive hyaluronic acid not only helps restore tissue health but also alleviates related symptoms such as burning, dryness, and painful intercourse (dyspareunia).
OSIDRA is therefore an effective complementary treatment within integrated protocols for managing stress urinary incontinence, suitable for both early and advanced stages due to its excellent safety profile, ease of use, and broad efficacy across vaginal, urological, and dermatological areas.
The product is available as a 50 ml spray, with dosages ranging from 1 to 3 ml daily, depending on treatment needs. It should be held under the tongue for at least 60 seconds to maximize absorption.
Beyond urinary incontinence, Osidra is also used in gynecology to treat:
- vaginal dryness and postmenopausal atrophy
- itching, burning, anddyspareunia
- interstitial cystitis and radiation-induced cystitis
- chronic pelvic pain
Thanks to its multi-tissue action, Osidra is also employed in dermatology and aesthetic medicine to improve skin hydration and elasticity, promoting collagen and elastin production.
For women over 40, often facing hormonal changes and their effects on the urogenital system, Osidra offers a scientifically based and clinically tested approach that effectively complements traditional treatments and significantly improves quality of life.
When is surgery necessary?
In cases of severe incontinence, the doctor may recommend surgery. The most common procedures include:
- Urethral sling (TVT or TOT): placement of a supportive tape under the
- Colposuspension: lifting of the anterior vaginal wall to support the
The ICS (International Continence Society) guidelines recommend surgery only after conservative treatments have failed, carefully weighing risks and benefits. These interventions are generally effective but require recovery time and individual assessment.
Conclusions
Stress urinary incontinence is not a fate to silently accept but a treatable condition, especially when addressed early and with an integrated approach.
Combining exercises, physiotherapy, and regenerative hyaluronic acid products like Osidra offers a proven, non-invasive approach to significantly enhance the quality of life for women experiencing this condition.
Interested in discovering more about Osidra and how it helps restore tissue tone?
Visit the official page: Osidra – Eidon Salus
