Alison
A difficult labour left Alison with a uterine and vaginal wall prolapse. A keyhole sacrohysteropexy with Mr Broome lifted the uterus back into place and let her go on to have a healthy second baby.
Read moreConditions & Treatments
Stress Incontinence
Leaking urine with a cough, a sneeze, a laugh or a run is called stress incontinence. It affects around one in three women at some point, and around half of women over 65.
At The Pelvic Clinic Mr Broome offers a full urogynaecology assessment, supervised pelvic floor training, urethral bulking injections and sling surgery, with an honest discussion of the risks and benefits of each.
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Overview
What is stress incontinence?
Stress incontinence is the involuntary leakage of urine when the pressure inside the abdomen rises, typically with coughing, sneezing, laughing, lifting or exercise.
It happens when the muscles and ligaments that support the urethra and bladder neck weaken, so the urethra can no longer stay closed against a sudden rise in pressure.
What to Look For
Symptoms of stress incontinence
Leaking with a cough or sneeze
A sudden small leak of urine every time you cough, sneeze or laugh.
Leaking with exercise
Damp underwear, or a full leak, during running, jumping or spin class.
Leaking with lifting
Losing a little urine when lifting a child, a shopping bag or heavy objects.
Wearing pads for reassurance
Using a pantyliner or pad every day just in case, even when not on your period.
Avoiding activities
Cutting back on the gym, trampolining or social plans because of leakage.
Reduced confidence at work
Worrying about smell, damp clothes or having to change during the day.
Stress incontinence is common but is not normal. First-line treatment is simple and works well for most women.
What Causes It
Causes of stress incontinence
Several factors weaken the pelvic floor and the support of the urethra. The most common are described below.
Vaginal childbirth
Delivery stretches and can damage the nerves, muscles and connective tissue that support the bladder neck, and remains the biggest single risk factor for later stress leakage.
Menopause and low oestrogen
Oestrogen keeps the urethral lining and pelvic floor supportive tissues healthy. As levels fall in perimenopause and beyond, leakage often appears or worsens.
High impact and heavy lifting
Repeated jumping, running or heavy lifting places sudden downward pressure on the pelvic floor. Over time this can weaken the support of the urethra.
Chronic cough or constipation
A long-standing cough or persistent straining on the toilet repeatedly loads the pelvic floor, and both are strongly linked to stress incontinence.
Treatments Available
How we treat stress incontinence
From pelvic floor rehabilitation to modern office procedures and specialist surgery, we choose the least invasive option that will work for you.
Pelvic Floor Physiotherapy
Supervised pelvic floor training with a specialist physio strengthens the muscles supporting the bladder. For many women it settles leakage entirely.
Vaginal Oestrogen
A low-dose oestrogen cream or pessary restores the strength and elasticity of the tissues around the urethra, particularly around and after menopause.
Urethral Bulking
An office procedure that injects a soft gel around the urethra to close it against pressure. Recovery is same day with no cuts and minimal downtime.
Autologous Fascial Sling
A mesh-free sling made from your own tissue supports the urethra during cough, sneeze and exercise. The standard surgical option where bulking is not enough.
About Mr Broome
A senior specialist women travel across the UK to see
Mr Jonathan Broome (MBChB, MRCOG) is a Consultant Gynaecologist known locally and nationally for treating pelvic floor disorders such as urinary incontinence and prolapse, alongside heavy or painful periods, endometriosis, fibroids and menopausal problems. He founded The Pelvic Clinic to give women the time, care and clear answers their symptoms deserve.
- Consultant Gynaecologist, MBChB, MRCOG.
- Over 30 papers published in peer-reviewed medical journals.
- A urogynaecology expert consulted by institutions worldwide.
- Keyhole prolapse repair, often without the need for hysterectomy.
In Our Patients’ Words
Treated with discretion and respect
Verified reviews from patients seen by Mr Broome, shared through Doctify.
Real Patient Journeys
Stress Incontinence case studies
A snapshot of what treatment for stress incontinence can look like at The Pelvic Clinic.
Jane
Years of flooding periods and iron-deficiency anaemia caused by fibroids. A keyhole myomectomy with Mr Broome removed the fibroids, restored Jane’s iron levels within three months and brought her cycle back to normal.
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Kate
Kate had been living with severe pelvic pain from endometriosis for over a decade. Laparoscopic excision surgery with Mr Broome removed the deposits and she returned to work and regular exercise pain-free.
Read more
Kaye
After menopause Kaye developed a bothersome vaginal vault prolapse that stopped her running and swimming. A laparoscopic sacrocolpopexy with Mr Broome resolved the symptoms and she is back to daily exercise.
Read moreCommon Questions
Frequently asked questions
Answers to the questions patients ask most often about stress incontinence, assessment and treatment options at The Pelvic Clinic.
Is leaking with a cough or a sneeze normal?
Common is not the same as normal. Stress incontinence is very common but is not something you have to live with, and effective treatment is available at every stage.
What tests will I need?
A full history, an examination, a bladder diary and, in some cases, urodynamic testing to measure exactly how the bladder and urethra are behaving.
What is the first-line treatment?
Supervised pelvic floor training with a specialist women’s health physiotherapist. Around 70 per cent of women with mild to moderate leakage improve significantly with this alone.
What are urethral bulking injections?
Small injections around the urethra that plump up the tissues so the urethra closes better. It is done under local anaesthetic and you go home the same day.
Is mesh used?
Following the UK pause on transvaginal mesh, mesh slings are only offered after full discussion. Fascial slings using your own tissue and bulking agents are usually preferred.
How long is recovery after sling surgery?
Most women go home the same day, are back to desk work at two weeks and back to running and heavy exercise at around twelve weeks.
Will incontinence get worse over time?
It commonly does, particularly around and after menopause, so early treatment is easier and more effective than waiting until symptoms are severe.
Can I still do high-impact exercise?
Yes, and with treatment most women return fully to their sport. A structured return-to-run programme after any surgery or rehab is important.
Do I have to have surgery?
No. Many women are treated successfully with physiotherapy and bulking injections. Surgery is only recommended when other options have not worked or are unsuitable.
How quickly can I be seen?
Self-pay and insured patients are usually seen within a week or two. Investigations and physiotherapy referrals are arranged at the first appointment.
