Stress Urinary Incontinence – What is it?



By Joseph Gauta, MD, FACOG

Stress Urinary Incontinence (SUI) can be stressful and embarrassing. This condition affects women in greater numbers than men.

Stress Incontinence is a condition when physical movement increases pressure on the bladder prompting the unintentional loss of urine. Those who suffer from this disorder have difficulty leading normal lives and can experience frustration and depression as a result.

In a normal situation, the muscle surrounding the urethra known as a sphincter constricts to contain the urine within the bladder. At the same time, the muscle that makes up the bladder wall relaxes to allow the bladder to expand. When the sphincter is weakened, the ability to control the bladder is impaired. There are many conditions that can lead to the weakening of the  sphincter; these include injuries, surgery, childbirth, or even certain medications. Even smoking has been linked to the increased probability of Stress Urinary Incontinence. Along with respiratory issues like asthma and bronchitis, the chronic coughing caused by smoking often leads to the weakening of the pelvis area and the sphincter. For sufferers, this uncontrollable urine loss can occur at any time of day. It can happen when you sneeze, laugh too hard, or during a vigorous workout. Unfortunately, even doing activities that seem harmless can cause this incontinence.

What can be done? Well, there is a proven procedure that can drastically reduce the threat of incontinence. It involves the surgical placement of a mid-urethral sling, which is a mesh strip that supports the urethra. Once a urethra has “fallen” out of place, it needs to be lifted back to its original position to relieve any extra pressure. The surgical incision is small and, therefore, reduces the occurrence of unwanted complications.  This polypropylene mesh is not only supported and approved by the US Food and Drug Administration (FDA), but has been the focus of multiple government funded studies. These studies have shown the use of these slings to be efficient, safe, and highly successful. The mid-urethral slings have been used in US for more than 25 years. Dr Gauta has successfully placed nearly 2000 slings in happy patients. Recent attorney TV commercials mistakenly mention slings as a cause of concern, though the success and safety of slings has been proven in long-term studies.

All of these procedures are able to be done on an outpatient basis. With any surgical procedure, there should not be any vigorous physical activities until the area has had enough time to heal. Some additional suggestions to increase its chances of success include weight loss, pelvic exercises, and the cessation of smoking. SUI can be an embarrassing problem, but with proper treatment there is hope. As always, if you have any questions or concerns about incontinence, give us a call.

Locally, the founder of The Florida Bladder Institute, Dr. Joseph Gauta, is the region’s premier Urogynecologist and can be reached at (239) 449-7979. The Florida Bladder Institute is located at 1890 SW Health Pkwy, Ste 205 in Naples or you can visit them online at

Joseph Gauta M.D.
Board Certified Urogynecologist

Dr. Gauta is now the first physician in S.W. Florida dual board certified in Urogynecology and Obstetrics and Gynecology. Dr. Gauta’s practice, The Florida Bladder Institute, is  solely  dedicated  to Urogynecology.

One out of every six women suffers from overactive bladder and half of all women will suffer from pelvic organ prolapse. A challenge for women seeking treatment is that they would go to a urologist for one problem, a gynecologist for another and a gastroenterologist for another. Dr. Gauta explains “A Urogynecologist has the skill and experience to assess the entire pelvic region including the uterus, bladder, vagina, rectum as well as the muscles, ligaments, connective tissue and nerves that support those systems. Evaluating your pelvic system as a whole ensures the best treatment and outcome”. Some of the newer treatment options include biofeedback, electrical stimulation, Botox, and minimally invasive outpatient surgery. In addition to providing the most advanced medical care for his patients, Dr. Gauta is a preceptor for Boston Scientific, Medtronic and Olympus and trains other physicians from around the world on how to do the most advanced Urogynecology procedures. He is the recipient of the prestigious Castle Connolly’s Top Doctors award, and is amongst the top 1% of physicians in the country who are honored with the Patient’s Choice Award for 5 years in a row. Dr. Gauta received his training at Tulane University in New Orleans mentored by world renowned Urogynecologists David Herbert M.D. and Thomas Elkins M.D.

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