Stress urinary incontinence in women removing the barriers to exercise.
Stress urinary incontinence-urine loss that follows a sudden increase in intra-abdominal pressure-is common in women and can be a major barrier to exercise. It often occurs with a cough or sneeze, routine activities, or exercise and is caused by derangement of the pelvic supportive structures as a result of aging, birth trauma, or collagen defects. Initial evaluation should consist of a thorough history that includes a voiding diary, a pelvic exam, and, possibly, a cough stress test. Referral for urodynamic testing may be necessary. Conservative therapies such as intravaginal or barrier devices and/or pelvic muscle strengthening techniques are often effective and should be tried before surgical repair is considered.
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Department of Obstetrics and Gynecology, State University of New York Health Science Center, Syracuse, NY, 13210, USA.