Stress urinary incontinence (SUI) is leaking urine when you laugh, cough, sneeze or exercise. It happens when sudden pressure on the bladder is more than a weakened pelvic floor can hold back. It is very common, especially after pregnancy, childbirth and menopause, and the first-line treatment in clinical guidelines is supervised pelvic floor muscle training for at least three months.
What Is Stress Urinary Incontinence?
Stress urinary incontinence means urine leaks when something suddenly presses on your bladder: a cough, a sneeze, a big laugh, a jump or a run. The word “stress” refers to that physical pressure, not to feeling anxious.
The pelvic floor is a group of muscles at the base of the pelvis. Together with the tissues around the urethra (the tube that carries urine out of the body), it helps keep urine in when pressure rises. When that support is weaker, a little urine can escape.
Stress leakage is the most common type of bladder leakage in women, according to the Office on Women’s Health. About half of U.S. women experience bladder leakage (NIDDK). In a national survey, 37.5% of U.S. women with leakage had the stress type, and another 31.3% had mixed incontinence, meaning stress leaks plus urgency leaks (Patel 2022). Men can have stress leaks too, often after prostate surgery.
What Causes Stress Incontinence?
Anything that weakens the support around the bladder, or keeps adding pressure from above, can lead to stress leaks. Common causes include:
- Pregnancy and vaginal birth. Both can weaken the muscles and tissues that support the bladder. If your leaks started after having a baby, read about bladder leaks after having a baby and what helps.
- Menopause. Lower estrogen can weaken the urethra and the tissues that support it.
- Prostate surgery in men. Stress leakage often follows a radical prostatectomy (surgery to remove the prostate). See pelvic floor therapy for men after prostate surgery.
- High-impact exercise. Running and jumping put repeated pressure on the pelvic floor. A 2018 review found that 36% of female athletes have urinary incontinence.
- A long-lasting cough. Every cough presses down on the bladder, so a cough that lingers for weeks repeats that strain many times a day.
- Extra body weight. More weight means more steady pressure on the bladder and pelvic floor.
Many people have more than one of these factors. Stress leaks are common, but they are not something you simply have to accept.
Stress vs Urge Incontinence: How to Tell Them Apart
Stress leaks are about pressure. Urge leaks are about a sudden, strong need to go that you cannot hold. Many women have both, which is called mixed incontinence. Telling them apart matters, because the first treatment is different for each.
| Feature | Stress incontinence | Urge incontinence |
|---|---|---|
| What happens | Urine leaks when a cough, sneeze, laugh or exercise puts pressure on the bladder | A strong, sudden urge to urinate, with leakage before you reach the toilet |
| Also called | SUI | Overactive bladder (OAB) or urgency incontinence |
| Quick self-check | Do leaks happen during a cough, laugh, sneeze or workout? | Do leaks follow a sudden urge you cannot hold back? |
| First-line care (NICE) | Supervised pelvic floor muscle training for at least 3 months | Bladder training for at least 6 weeks, then a medicine may be added |
| Other options | Pelvic floor physical therapy, a pessary, bulking agents, sling surgery | Medicines for overactive bladder, injections into the bladder muscle, nerve stimulation |
Not sure which type you have? Your doctor can help you work it out.
How Stress Incontinence Is Treated
Care usually starts with the simplest, least invasive steps and moves on only if they are not enough. The complete guide to bladder leakage treatment options walks through every step, from Kegels to surgery.
First-line: supervised pelvic floor muscle training
The NICE guideline recommends supervised pelvic floor muscle training for at least three months as the first treatment for stress leakage, with at least 8 contractions three times a day. The word “supervised” matters. In one study, after brief spoken instructions, only 49% of women did an ideal Kegel, and 25% used a technique that could make leakage worse (Bump 1991). A pelvic floor physical therapist can check that you are squeezing the right muscles the right way.
Give it time. MedlinePlus notes that people who do Kegels regularly may have fewer symptoms after 4 to 6 weeks, and it can take a few months. If you have been at it for a while and nothing has changed, read why Kegels may not be working and what to try next.
Other options if exercises are not enough
- Pelvic floor physical therapy with biofeedback. Biofeedback helps you see whether you are using the right muscles. NICE suggests biofeedback or electrical stimulation for women who cannot actively contract the pelvic floor.
- A pessary. A removable device worn in the vagina to support the bladder.
- Vaginal estrogen. For bladder symptoms linked to menopause, a doctor may prescribe low-dose vaginal estrogen.
- Procedures and surgery. Options include bulking agents and sling surgery. For men, they include a male sling or an artificial urinary sphincter.
Where pelvic floor chair therapy fits
Some people consider a pelvic floor chair when exercises have not helped enough, or when Kegels are hard to do correctly. Pelvic floor chair therapy at Elume is provided by Restore Innovations, an independent practice located within Elume Medspa. The Pelvic Wave chair uses an electromagnetic field in the seat, reaching up to 4 inches deep, to cause involuntary pelvic floor contractions: more than 5,600 in a 20 minute session, according to the manufacturer. You sit fully clothed, nothing is inserted, and there is no internal exam.
According to the manufacturer, the chair’s technology is FDA-cleared for the treatment of urinary incontinence in women. The research on magnetic chairs is still limited. A 2021 meta-analysis of six small sham-controlled trials found magnetic stimulation reduced stress leakage in women compared with a placebo treatment, although the authors flagged study-quality problems. A 2025 systematic review of five small studies (about 219 women) found chair-based magnetic stimulation was associated with less leakage, but rated that evidence low certainty. None of these studies used the Pelvic Wave chair; they tested other magnetic devices.
Magnetic chairs are not part of the NIH or NICE treatment ladders, and some insurers, including Aetna, classify magnetic pelvic floor stimulation as experimental. Think of chair therapy as one option to discuss, not a replacement for medical care. The pelvic floor therapy page explains how the 24-session, 8-week program works.
When to See a Doctor
Women wait more than six years on average before seeking help for leakage, according to the National Association For Continence. There is no need to wait. Bring up any leaks with your doctor, and see one promptly if you notice blood in your urine, pain or burning when you urinate, a fever, sudden new symptoms, trouble emptying your bladder, or leakage that started after a new medicine. These can point to a problem that needs its own care.
Frequently Asked Questions
What is the difference between stress and urge incontinence?
Stress incontinence is leakage when a cough, sneeze, laugh or exercise puts pressure on the bladder. Urge incontinence is a sudden, strong need to urinate with leakage before you reach the toilet, and it is often called overactive bladder. Many women have both, which is known as mixed incontinence.
Can Kegels fix stress incontinence?
Pelvic floor muscle training is the first-line treatment for stress leakage, and NICE recommends doing it with supervision for at least three months. Technique matters, because many people squeeze the wrong muscles without realizing it. MedlinePlus says symptoms may ease after 4 to 6 weeks of regular practice, though it can take a few months.
Does the pelvic floor chair really work?
The evidence is limited. Small trials and reviews of magnetic stimulation found less stress leakage in women, but the authors flagged study-quality problems and rated the evidence low certainty. None of those studies used the Pelvic Wave chair, so it is best seen as one option alongside first-line care, not a sure thing.
Is surgery the only option if exercises do not work?
No. Between exercises and surgery there are several steps, including pelvic floor physical therapy with biofeedback, a pessary, vaginal estrogen for menopause-related symptoms, and bulking agents. Some people also consider pelvic floor chair therapy. Sling surgery is usually considered after less invasive options have been tried.
Talk It Through With Restore Innovations
If stress leaks are changing how you live, a first conversation is free. Restore Innovations sees people by appointment only. You can book a free 15 minute phone consultation (they call you) or a free 30 minute consultation in person at the suite inside Elume Medspa, 3925 Blenheim Blvd, Suite 53-D, Fairfax, VA 22030. Prefer to call? The number is (571) 299-8780. If a plan is recommended, the full cost is explained before your first session.
Sources
- Bladder Control Problems and Urinary Incontinence, NIDDK (accessed 2026)
- Urinary incontinence in U.S. women, NHANES 2015-2018 (Patel et al.), Female Pelvic Medicine and Reconstructive Surgery (2022)
- Urinary incontinence and pelvic organ prolapse in women: management (NG123), NICE (2019)
- Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction, American Journal of Obstetrics and Gynecology (1991)
- Efficacy of magnetic stimulation for female stress urinary incontinence: a meta-analysis, Therapeutic Advances in Urology (2021)
- Systematic review of chair-based magnetic pelvic floor stimulation in women with urinary incontinence (Sacarin et al.), Journal of Clinical Medicine (2025)
- Clinical Policy Bulletin 0223 on urinary incontinence treatments, Aetna (accessed 2026)
- We Count, National Association For Continence (accessed 2026)