Stress incontinence means that the bladder leaks urine when put under sudden pressure e.g. coughing, sneezing, laughing, aerobics etc. Weak pelvic floor muscles are one of the main causes of this type of leaking. It can affect people of all ages but often starts during pregnancy, after childbirth or the menopause when the muscles of the pelvic floor become weak and lose tone. The good news is that once stress incontinence is diagnosed, leakage can usually be improved by exercising the pelvic floor muscles.

The pelvic floor is a layer of supportive muscle that lies like a sling between your thighs. These muscles lie at the base of the pelvis. The back passage (anus), birth canal (vagina) and urinary passage (urethra) pass down through them.

Functions -

1. Prevent leakage of urine on sudden movements.
2. Support the contents of the pelvis e.g. the bladder, bowel and uterus.
3. They affect the enjoyment of sexual intercourse for both partners.

They may be done in any position, but these may be best to start with -

1. Lying on your back with your knees bent and comfortably apart.
2. Sitting down (leaning forward, resting your elbows on your knees).
3. Standing with feet slightly apart (more difficult).

To contract the pelvic floor muscles -

1. Pull up the muscles around your back passage (as if trying to stop the passage of wind) and at the same time pull up the muscles around your vagina and urinary passage (as if trying to stop passing water). Hold as strongly as possible, then relax and rest for a few seconds.
2. Try not to hold your breath or tighten your buttocks or squeeze your legs together.

Repeat stages 1 and 2 as many times as possible for a couple of minutes or so, several times a day. It is a good idea to empty your bladder before doing the exercises, so why not try doing them after you have passed water when still sitting on the toilet.

It is not advisable to practice "stopping and starting" mid stream when you are passing water. Do not expect too much too soon - weak muscles tire easily.

1. The Counter Brace. If you are about to lift, push, cough, laugh, blow, sneeze or do any action that causes a downward pressure, prepare yourself to take the increased stress by contracting your pelvic floor and holding it tightly until the exertion is over.
2. Being Overweight. This gives the muscles extra work to do. Getting down to your correct weight can make a considerable improvement to your symptoms.
3. Constipation. Straining to force the bowels open stretches the pelvic floor. Diet is the best way to cope with constipation, try to keep a healthy fibre diet with plenty of fresh fruit, vegetables and wholemeal bread.
4. Liquid Intake. You should drink approximately 1500 to 2000 mls (about 6 - 7 mugs) of liquid a day. NO NOT restrict your intake - it will not make you leak less. If you don't drink enough your bladder will be irritated by the small volume of strong urine which could make things worse.
5. Heavy Lifting. Puts a strain on the pelvic floor so repeated heavy lifting should be avoided when possible. If you need to lift something heavy remember to tighten the pelvic floor muscles before you do so, continuing until after you have put the load down.
6. Strenuous Tummy Exercises. Such as sit ups and double leg lifts (lying down and lifting both legs together) put severe pressure on the pelvic floor and must not be done if they cause leakage.
7. Frequency of Bladder Emptying. Try not to get into the habit of emptying your bladder too frequently as this can reduce its capacity. Do not develop bad habits by going (voiding) "just in case". Up to eight times a day is considered the normal.
8. Bladder Emptying. It is important to completely empty your bladder each time you go to the toilet. Any small amount of urine left inside may irritate the bladder lining and cause inflammation. If you feel you may not have fully emptied your bladder try standing up, turning around and sitting back on the toilet, then try to pass water. When passing water you will not be able to completely empty your bladder if you do not sit on the toilet seat. It may also help to lean forward as you push to pass urine. Take your time to empty your bladder - do not rush.

This is a mystery to some people, but the answer is both normal and natural. The body absorbs unused sperm cells normally - whether or nor you've had a vasectomy. After the procedure, the testicles will continue to produce sperm, but they will not leave the body in the semen. They dissolve and are simply and naturally absorbed by the body.

A vasectomy only blocks sperm and does not affect your sexual drive, your ability to have an erection, orgasm or ejaculation or your ability to have and enjoy sex. Sperm is only a small fraction of the total liquid in your semen. The amount of fluid, intensity - even color and texture - does not appear to change when sperm is absent. Male hormones continue in the bloodstream, and secondary characteristics (such as beard or voice) do not change. Some couples say their relationship is improved by not having to worry about contraceptive techniques or unplanned pregnancy.

Yes, as with any surgical procedure, there could be complications and you should ask your doctor to go over these carefully with you. However, any type of vasectomy ranks among the safest procedures and the majority of complications, if any, are usually minor and easily treated. These include a chance of infection, bleeding or transient bruising, temporary swelling or fluid accumulation.

Following the procedure, some men experience pain, often as a dull ache, caused by a pressure on the miniature tubes of the epididymis. This is usually treated successfully with medication, but the removal of the epididymis is sometimes recommended.

Some studies have found that some men, who had a vasectomy 20 years earlier, have a slightly higher risk of prostate cancer than others who did not have a vasectomy. Other studies did not have the same results. The American Urological Association and the American Cancer Society recommend that men over the age of 50 should have a regular prostatic examination and a PSA blood test to help detect early prostate changes. This recommendation is the same for all men in this age range (50 to 70), including those who have had a vasectomy and those who have not had the procedure.

You should consider any vasectomy to be permanent. There are delicate microsurgery operations that may be able to reverse the effects of a vasectomy, but there is no assurance that the flow of sperm can be restored or pregnancy will result in every case. The likelihood of success can vary greatly depending on individual circumstances, including how much time has passed since the vasectomy. If you are seriously considering a vasectomy, it's best to assume that it will be a permanent change.

• Be prepared to ask a lot of questions; informed decisions are best.
• Always discuss your issues with the doctor of your choice.
• A vasectomy is a simple, safe and highly effective procedure.
• Results are not immediate; it may be months before sterility is complete.
• Vasectomy does not change your ability to have an erection or enjoy sex.
• The procedure is safe, risks are low and complications are rare.
• A vasectomy should be considered permanent and may not be able to be reversed later.