Many women encounter unpleasant surprises during jumping, sneezing, or laughing. Gynecologist Alexander Kulkin explained that the cause may be excessive mobility of the urethra or insufficiency of its sphincter, and special examinations help determine the mechanism of the problem... reports the website infohub.kz.
"Stress urinary incontinence is when urine leaks during coughing, laughing, jumping, or sneezing without an 'unbearable urge.' And it doesn't automatically mean 'weak pelvic floor muscles.' The mechanics are simple: when you cough, intra-abdominal pressure rises. Normally, the urethra should 'close and hold.' But if the closure-support system fails, incontinence occurs. Why? There are several reasons," explains the doctor.
Reason #1: According to the gynecologist, the most common cause of incontinence is urethral hypermobility. "That is, the urethra and bladder neck are too mobile because their 'support' (fascia, ligaments, anterior vaginal wall) has weakened. This often happens after childbirth," he explains.
Reason #2: The second cause may be intrinsic sphincter deficiency (ISD). The doctor notes that the support may be almost normal, but the 'valve' doesn't close tightly, so leakage occurs even with minimal exertion. "To avoid treating blindly, we need to understand: is the problem more about mobility or the sphincter? One of the quick office tests is the Q-tip test," he says.
How the test is done: "A sterile cotton swab is gently inserted into the urethra to the level of the bladder neck, the angle is measured, the patient is asked to cough or strain, and we observe how much the swab deflects," explains Kulkin. Interpretation is simple, according to the doctor. If the deflection is about 30 degrees, it usually indicates urethral hypermobility (poor support). "If mobility is small but symptoms are pronounced, we think more about the sphincter. Importantly, the Q-tip test is not a definitive diagnosis or the only criterion. We usually supplement it with a cough stress test, examination for prolapse, and symptom assessment," the doctor explains.
Pelvic organ prolapse in women is a condition where the uterus, bladder, vaginal walls, or rectum descend from their normal position due to weakening of the pelvic floor muscles and ligaments.