Urinary incontinence in women is called. Urinary incontinence in women: causes and treatment. Biofeedback in the treatment of stress urinary incontinence in women
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Urinary incontinence in women (incontinence) is a pathological disorder of urination, in which the patient cannot fully control the process. Most often, just a few drops of urine are released, but in some cases there is a complete uncontrolled emptying of the bladder.
Causes, as well as treatment of urinary incontinence in women can be different. Understanding the essence of what is happening, namely why the internal muscles have ceased to cope with the usual load, allows the doctor to choose an effective therapy tactic and completely defeat the problem. It is important to know that urinary incontinence can be cured at any age, the main thing is to contact a specialist in a timely manner and unconditionally follow all his recommendations.
According to statistics, every fifth woman complains of uncontrolled spontaneous urination. Depending on the anatomy of the genitourinary system, it can be true or false. In the second case, we are talking about pathologies of the location of the bladder or urethra - fistulas, injuries and birth defects.
The vast majority of cases of sudden urination in adult women is true. That is, with normally located internal organs, a woman cannot hold back urine during sneezing, coughing, at the sounds of flowing water, or in other situations.
Over time, such incontinence can grow from an annoying nuisance into a real problem. If at first we are talking about the leakage of a small amount of urine, then without treatment the volume of discharge increases. A woman begins to experience psychological complexes associated with the fear of suddenly urinating in the presence of people, during sex, or not running to the restroom. This condition negatively affects the standard of living and can even lead to depression.
What are the symptoms of involuntary urination in women
Involuntary excretion of urine in women can manifest itself in different ways:
- Leakage of urine during exercise. It can be not only weight lifting, but also banal sneezing, coughing, attempts to defecate.
- Urinary incontinence during intercourse. Usually, its probability increases when choosing positions when the partner puts physical pressure on the bladder, for example, finds it from above.
- Morning incontinence occurs when a woman gets out of bed. Weak muscles cannot contain the increased pressure of the bladder, which has arisen due to a sharp change in body position from horizontal to vertical. Usually the bladder is full after a long sleep.
- Spontaneous urination under the influence of an irritant. For every woman, it can be individual. Often patients refer to the sound or sight of flowing water, bright light. Such urges occur frequently and may be so strong that they end in an uncontrolled separation of urine.
Frequent urination - more than 8 times a day - is also a symptom of incontinence. With normal fluid intake, this may indicate an overactive bladder. In this case, the woman may not suspect that she is suffering from urinary incontinence, and therefore does not seek help from specialists.
What are the types of involuntary urination?
Depending on the reasons that caused it, doctors developed the following classification:
- Stress urinary incontinence in women is associated with weakening of the internal muscles of the pelvic floor or disruption of the sphincter of the bladder.
- Urinary incontinence in women is also called overactive bladder syndrome, which sends signals to empty before it is physically full.
- Mixed - combines the symptoms of the first two types.
- Reflex - manifests itself in violations of the innervation of the pelvic organs. It is extremely rare.
- Iatrogenic incontinence - uncontrolled separation of urine due to the use of certain drugs, which disappears after discontinuation of therapy.
- Situational urination - occurs during intercourse or with true overflow of the bladder.
It is worth noting that the vast majority of clinical cases faced by doctors belong to the first two types of incontinence. They account for about 90% of all calls.
Stress incontinence and its subtypes
Stress incontinence is due to the fact that the pelvic muscles and the sphincter of the bladder in women, for a number of reasons, become insolvent, that is, they cannot cope with the usual load. It first appears as a drip of urine during sneezing, coughing, or other physical activities (such as having sex). In this case, women may complain of the simultaneous separation of small amounts of feces or intestinal gases.
The causes of incontinence are:
Pregnancy. It can provoke incontinence even in young women. Due to the ever-increasing size of the uterus, the pressure on the bladder and intestines increases, which contributes to the uncontrolled separation of their contents. In addition, fluctuations in the hormonal background cause atony of the muscles, which are unable to withstand the ever-increasing physical load. Uncontrolled urination during pregnancy is the most favorable in terms of prognosis, because after childbirth it may disappear on its own.
Childbirth. Although they are related to the previous factor, delivery is a distinct trigger for urinary incontinence. Particularly negative impact on the condition of the muscles of the pelvis natural childbirth with prolonged attempts, internal ruptures and episiotomy. Subsequently, the girls experience urinary, fecal and gas incontinence, which, depending on the intensity and the presence of other diseases, can go away on its own or, on the contrary, progress with age.
Abdominal operations on the pelvic organs. Any surgical intervention can contribute to the formation of adhesions. They cause chronic urinary incontinence due to changes in intraperitoneal pressure.
Menopause. Urological problems are familiar to 50% of women who have entered menopause. As women age, the number of women suffering from incontinence rises to 75%. This is due to a deficiency of estrogens - female sex hormones that affect the elasticity of the pelvic muscles and metabolic processes.
Stress incontinence causes many problems for women. Because of him, they refuse to lead their usual way of life, appear in public, play sports, and lead an intimate life. It is very important to discard false shame in time and consult a doctor. Modern medicine can offer several types of treatment from conservative to surgical intervention.
imperative urination
Imperative urge to urinate appears under the influence of external factors. They can be so strong that a woman simply does not have time to reach the nearest toilet. This is due to increased irritability of the bladder muscles, which requires emptying even with a minimal amount of urine. The reasons for this overactive bladder are not yet known.
Unlike stress incontinence, this type of incontinence rarely occurs during exercise, running or brisk walking. It can manifest itself as nocturnal enuresis and is aggravated by alcohol intake or in connection with an exacerbation of inflammatory diseases of the pelvic organs. Thus, the treatment of imperative urinary incontinence in women should begin with the abandonment of bad habits and a visit to the gynecologist.
How to identify urinary incontinence
If a woman suffers from urinary incontinence, then she needs to seek help, first of all, from a urologist and gynecologist. Such a tandem will help not only to correctly diagnose, but also quickly cure urinary incontinence.
For diagnosis, the following activities and manipulations are carried out:
Medical history - that is, the collection of information about the patient's lifestyle, symptoms and the presence of concomitant diseases.
- PAD-test - consists in counting the number of pads used by a woman per day. It makes it possible to assess the severity of incontinence in the patient.
- Gynecological examination on the armchair. Often, with urinary incontinence in women, omission or prolapse of internal organs is recorded, which the doctor should notice.
- Complete urinalysis - This simple test looks for inflammation of the bladder (cystitis) or urethra (urethritis), symptoms of which may include pain when urinating and incontinence.
- Ultrasound is a quick and painless study that allows you to visually assess the condition of the bladder, ureters, urethra and other organs of the small pelvis.
- MRI is a highly accurate imaging modality indicated when ultrasound examinations cannot give an accurate clinical picture.
- Urodynamic studies are a set of procedures aimed at studying the functions of the urinary system.
How is urinary incontinence treated?
Depending on the type of pathology, there are several groups of methods for treating urinary incontinence in women. The most common of these is Kegel gymnastics, which consists in sequential tension and relaxation of the internal muscles of the pelvic floor - periurethral and perivaginal. These exercises are aimed at strengthening the muscles involved in the act of urination, and have an excellent therapeutic and preventive effect. With their help, you can cure mild incontinence at home, but gymnastics must be performed regularly, up to 100 repetitions per day.
A more advanced option is biofeedback training, which allows you to control the effectiveness of gymnastics and is guaranteed to increase the tone of the bladder.
A good result is the use of various simulators for intimate muscles, as well as psychological training.
Treatment of stress incontinence
Treatment for stress urinary incontinence begins with medication. The following drug groups are shown:
- Adrenomimetics that increase muscle tone. Currently rarely used due to side effects.
- Anticholinesterase drugs with a similar effect.
- Antidepressants and drugs that affect the central nervous system. These agents are rarely used because of their low efficacy in stress incontinence.
If drug therapy does not give the desired result, then surgical intervention is indicated.
There are several types of surgeries for urinary incontinence in women. The choice between them always remains with the doctor, who proceeds from the specific clinical picture of the disease.
Sling operations - a loop of synthetic material is placed under the bladder neck or urethra, which ensures the physiological position of the internal organs even with a significant increase in load. Injections of tissue-forming drugs, which also guarantee the correct position of the bladder, eliminating urinary incontinence.
Urgent incontinence treatment
Urgent incontinence is treated with medication. For this, drugs such as:
- Oxybutynin - reduces the tone of the bladder.
- Tamsulosin - relaxes the bladder and improves tissue trophism.
- Hormone replacement therapy is also carried out for women during menopause.
What to do with urge urinary incontinence if the medications listed above do not help? Experts recommend resorting to general therapies, including psychological training.
How to deal with urinary incontinence folk remedies
Of all the ways and means of traditional medicine, there is not one that would be guaranteed to cure all types of urinary incontinence. However, they may be useful in mild forms of enuresis, as well as in concomitant inflammatory diseases of the urinary organs. For example, the herb yarrow enhances diuresis. Thus, the amount of urine that a woman writes out increases. This helps to remove salts and infection from the bladder, relieving the symptoms of cystitis or urethritis.
It is worth noting that self-medication in case of incontinence is not worth it. There is a chance to start the disease, which will lead to even greater somatic and psychological problems. It is better to ask a urologist about how to treat urinary incontinence, who will conduct a thorough diagnosis and select the best therapy option.
What else can be done to get rid of incontinence
Very often, urinary incontinence can be eliminated by adjusting your lifestyle and giving up bad habits. If the cause of stress urinary incontinence in a woman is a cough, then you should stop smoking or visit an allergist to identify other causes of persistent coughing. Doctors strongly advise against drinking alcohol, which can become a problem of morning incontinence or nighttime urine leakage. Sometimes, to prevent arbitrary urination, it is enough to lose a few kilograms. Obesity is an important risk factor for all women.
If with the help of these actions it was not possible to get rid of the problem, then you should immediately consult a doctor.
Prevention of uncontrolled urination
In a woman's body, all processes are so interconnected that the best prevention of uncontrolled separation of urine is the timely treatment of gynecological, endocrine, urological and psychological diseases.
Every girl from her youth should perform Kegel exercises daily, which, in addition to preventing incontinence, is also an excellent preparation of the pelvic muscles for the upcoming birth.
Urinary incontinence is the flow of urine that is not controlled by a person, which is detected visually.
According to statistics, urinary incontinence occurs in 14-56% of cases. But these indicators are very contradictory, since the number of people seeking medical help for this disease is very low.
Classification of urinary incontinence
Urinary incontinence is divided into true and false.
False urinary incontinence is the involuntary release of urine, in which a person does not feel the urge to urinate. The causes of false urinary incontinence may be congenital or acquired defects of the ureter, urethra or bladder. As a rule, acquired defects occur as a result of an injury that violates the integrity of the urinary tract.
True urinary incontinence is the involuntary release of urine that is visually observable and causes hygiene and social problems.
True urinary incontinence is divided into:
- stress incontinence resulting from excessive exertion;
- urge incontinence - involuntary urination with a previous urgent urge;
- mixed incontinence - a combination of urgency and stress incontinence;
- enuresis - any uncontrolled loss of urine;
- Bed-wetting;
- permanent enuresis;
- situational urinary incontinence (with strong laughter or sexual intercourse).
The causes of true urinary incontinence can be many factors. This symptom is observed with injuries of the spinal cord, advanced cystitis, spinal hernia, complicated wrinkling of the bladder.
Stress incontinence is caused by weakened bladder sphincters and weak pelvic floor muscle tone. In men, urinary incontinence often occurs after surgery on the bladder neck, seminal tubercle or prostate gland. In women during menopause, the cause of urinary incontinence is a violation of the function of the closure apparatus of the bladder or a violation of the tone of the detrusor due to estrogen deficiency.
The main causes of urinary incontinence are:
- advanced age;
- estrogen deficiency in women during menopause;
- circulatory disorders;
- infravesical obstruction;
- sensory disturbances;
- influence of serotonin and prostaglandins;
- anatomical changes in the position of the bladder and urethra;
- myogenic disorders.
Bedwetting occurs mainly in children, although it also occurs in adults. The most common cause of bedwetting is fright or severe psychological trauma.
Diagnosis of urinary incontinence
A certain difficulty in the diagnosis of urinary incontinence is represented by various ectopias of the mouth of the ureter. As a rule, an ectopic mouth is determined by instrumental examination (examination of the vagina through a mirror, urethrocystoscopy, rectoscopy). Sometimes, to identify the cause of urinary incontinence, it is advisable to use an indigo carmine test. To do this, a 0.4% solution of indigo carmine is injected intravenously in an amount of 5 ml and observe how it will be excreted along with urine from the ectopic mouth.
Also in the diagnosis of urinary incontinence, the following methods are used:
- Examination on a gynecological chair. Using this diagnostic method, you can determine the presence and degree of prolapse of the walls of the vagina, cystocele, uterus.
- A cough test that provides visual evidence of stress incontinence.
- Padding test.
- X-ray methods of research, such as urethrocystography. Using these methods, it is possible to determine the shape of the bladder, the position of its neck and the dynamics of changes during stress and at rest.
- Ultrasonic diagnostic methods. A properly performed perineal ultrasound provides the same information as urethrocystography, only in this case the patient is not exposed to radiation exposure.
To select an adequate treatment for urinary incontinence, the basis is a urodynamic study of the patient, supplemented by a urination diary. Urodynamic study is carried out in order to determine the parameters of the evacuation and storage functions of the bladder.
Recently, the MRI method has become widespread in the examination of women with stress urinary incontinence.
Urinary incontinence treatment
Depending on the cause of the disease, the treatment of urinary incontinence may be:
- conservative;
- surgical (surgery for urinary incontinence).
Conservative methods are indicated for patients with mild stress incontinence, urge incontinence caused by overactive urethra or detrusor. The treatment of stress urinary incontinence has two directions: inhibition of detrusor activity and increase in the tone of the closure apparatus of the bladder.
It is believed that urge and stress urinary incontinence in women during menopause are the consequences of a lack of estrogen, so they are prescribed estrogen-containing drugs. As a rule, this leads to quite positive results.
With the conservative treatment of urinary incontinence, the doctor normalizes the patient's diet, increases his physical activity. The folk treatment of urinary incontinence should primarily include physiotherapy exercises. It helps to improve the blood supply to the pelvic organs, increases the compensatory function of the respiratory and cardiovascular systems, strengthens the musculoskeletal system and helps to normalize the mental state of patients.
For mild incontinence, folk remedies for urinary incontinence such as pessaries can help. They, of course, do not eliminate the cause of the disease, but they can help the patient avoid embarrassment. It should be noted that the patient is significantly inconvenienced by the need to remove the pessary before urination and its subsequent establishment. In addition, some patients note that when using a pessary, bedsores may appear.
A positive effect in the treatment of urinary incontinence is observed after electrical stimulation of the tissues and organs of the pelvis. And with a mild degree of urinary incontinence, some patients noted the positive effect of acupuncture.
Minimally invasive operations for urinary incontinence include injection treatment in women with severe prolapse of the bladder and vaginal walls, as well as with neurogenic urinary disorders. When carrying out injection therapy, Teflon paste, collagen, homogenized autofat and other substances are used.
It should also be noted transvaginal surgery for type 1-2 urinary incontinence - urethrocervicopexy. Recently, loop or sling operations for urinary incontinence have become widespread. As a free loop, a flap from the anterior wall of the vagina, a musculoaponeurotic flap, a skin flap, or synthetic materials are used. The final result of surgical treatment can be judged after at least three years after the intervention.
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Urinary incontinence (the medical name is incontinence) is the uncontrolled flow of urine through the urethra. There are true and false incontinence, in the second case, urination occurs through unnatural openings in the urinary tract. This disease brings not only physical, but also moral discomfort. Patients are often afraid to admit even a doctor about the presence of this problem. The inability to retain urination is inherent in many people around the world, and both young people (from 14%) and people older than middle age (from 40%) suffer from this pathology.
Classification
As mentioned above, there is false urinary incontinence that occurs without the urge to urinate. It occurs due to acquired or congenital defects of the ureter, urethra or bladder, as well as exstrophy of the bladder, total hypospadias and epispadias of the urethra, ectopia of the mouths of the ureters with their abnormal location. Acquired defects almost always occur due to trauma.
There are the following types of uncontrolled urination:
- Bedwetting or enuresis occurs mainly in childhood, in babies 5-6 years old. It can resolve spontaneously and often does not require special treatment. You can talk about its presence if a child of 5-6 years old urinates in bed more than twice a month and if an older child has a single involuntary emission per month.
- Urgent or imperative uncontrolled urination occurs with an initial urgent urge.
- Mixed incontinence - combines urgent and stressful voluntary urination.
- Constant incontinence.
- Situational incontinence.
Causes
The causes of urinary incontinence of the true type include such factors: spinal cord injury, advanced cystitis, spinal hernia, complicated shrinkage of the bladder. As a result of such pathologies, there is a weakening of the sphincters of the bladder and a decrease in the tone of the muscles of the pelvic floor.
For men, the causes of urinary incontinence can be complications after operations on the prostate gland, bladder neck or seminal tubercle. Causes in women in menopause are disorders affecting the tone of the detrusor and the function of the closure apparatus of the bladder, which leads to the development of estrogen deficiency.
There are two types of pathological uncontrolled urination:
- arising on the basis of a disease associated with dislocation and impotence of the ligamentous apparatus, weakening of the urethrovesical segment and unchanged urethra;
- frolicking on the basis of a disease associated with changes in the urethra itself, defects in the sphincter apparatus.
The following non-neurogenic causes of urinary incontinence are also noted:
- circulatory disorders;
- age;
- estrogen deficiency in women experiencing menopause;
- infravesical obstruction (IVO);
- myogenic and sensory disorders;
- influence of serotonin and prostaglandins;
- anatomical changes in the organs involved in the process of urination.
Symptoms
The most obvious symptom of this disease is the sudden and arbitrary flow of urine.
Symptoms of stress urination are small urination when sneezing, laughing, coughing, exercising, etc.
In the urgent type of the disease, the symptom is profuse spontaneous urination and the occurrence of frequent urge to urinate.
To diagnose this disease, the following research methods are used:
- examination on a gynecological chair;
- definition of cough test;
- gasket test;
- urethrocystography.
- urodynamic study, keeping a diary of urination;
Treatment
Depending on the causes of this disease, either drug therapy or surgery for urinary incontinence is performed.
People with a mild degree of the disease are prescribed drug treatment for urinary incontinence to increase the tone of the detrusor and the closure apparatus of the bladder. Treatment of the combined and urgent form can be aimed at inhibiting the activity of the detrusor.
Menopausal women with this disease are prescribed estrogens.
Also, the treatment of urinary incontinence includes such general measures as increasing physical activity, normalizing the diet, physiotherapy exercises, and acupuncture.
Sometimes surgery is indicated for urinary incontinence. Mostly resort to minimally invasive methods.
Urinary incontinence in women is a common condition in which urine cannot be retained in the bladder and involuntary release occurs.
It is currently known that this disease is of three types:
- stressful;
- urgent;
- mixed.
These are completely different forms of the disease, having different causes, symptoms, clinical presentations, and, therefore, completely different treatment.
stress urinary incontinence
Stress incontinence or stress urinary incontinence usually occurs with sneezing, coughing, laughing, physical activity, and other activities that increase intra-abdominal pressure.
This is the most common disease that affects over 30% of the female population of the planet, and it is more often observed in old age. Approximately 40% of all women at least once experienced a similar pathology.
The process of the course of this disease is explained by the fact that the neck of the bladder moves down, with increased intra-abdominal pressure, the sphincters do not “work” and urine is, as it were, “squeezed out” through the urethra (urethra) from the bladder.
Unlike other types of this disease, stress urinary incontinence is characterized by the fact that the bladder does not participate in urination, and its muscular wall remains relaxed when urine is lost. As a rule, urine is displaced in this case in small portions.
Causes of stress incontinence include:
- complex gynecological operations (removal of the uterus and other operations on the pelvic organs);
- difficult childbirth (large fetus, prolonged or accelerated labor, gross obstetric intervention, etc.);
- hard physical work;
- various hereditary defects of connective tissues (urinary incontinence in combination with varicose veins, hernia of the anterior abdominal wall, skin laxity, etc.);
- obesity;
- chronic diseases of the upper respiratory tract accompanied by a strong cough;
- chronic constipation;
- injury to the perineum.
Symptoms of the disease
Typically, patients complain of the following symptoms of the disease:
- frequent urge to urinate;
- a feeling of the presence of a foreign body in the vagina, which is usually associated with the prolapse of the genitals and bladder;
- urinary incontinence during exercise;
- feeling of a full bladder immediately after urination.
Stress urinary incontinence is diagnosed quite easily and is based on the examination data and a detailed clarification of the patient's complaints. However, for the correct diagnosis and the appropriate choice of treatment, special additional examinations are performed. With the help of a general and bacteriological analysis of urine, an examination is carried out for the presence of infection. A urodynamic study and cystography of the urinary tract will help to study the functions of the bladder and determine the degree of its prolapse.
Treatment of stress urinary incontinence
Urinary incontinence is treated with conservative or surgical methods.
If the disease is still at the initial stage of its development, then its treatment is electrical stimulation of the pelvic organs, acupuncture, physiotherapy exercises. In addition, patients are prescribed strengthening drugs that are injected into the tissues located around the urethra.
Conservative treatment methods include:
- treatment of chronic constipation, respiratory diseases;
- pelvic floor muscle training;
- physiotherapy treatment;
- fight against obesity.
In the vast majority of cases, in the treatment of this type of incontinence, conservative therapy is not very effective, since stress urinary incontinence occurs due to an anatomical defect in the musculofascial apparatus of the pelvic floor.
In more complex cases of the disease, surgical treatment is performed. It uses a variety of modern surgical techniques and aims to form additional support for the bladder and prevent its displacement.
Urgent urinary incontinence
Urge incontinence is a type of incontinence in which the patient feels the urge to urinate at short intervals and is unable to hold the urine.
With this type of disease, the bladder contracts without any control from the brain or is associated with its hyperactivity. Sometimes it is impossible to establish the cause of the disease at all.
In some women, a similar problem occurs even with a small amount of urine, sometimes they do not feel warning signs at all. Urinary incontinence in women can occur even at the sound of running water, touching the water with your fingers, or while drinking.
Patients with a similar problem complain of the following symptoms:
- on the way to the toilet it is difficult to hold urine;
- it is often necessary to get up at night to go to the toilet, otherwise bedwetting is observed;
- almost every two hours there is an urge to urinate.
Treatment of urge incontinence is usually most effective with modern medications.
Mixed urinary incontinence
Mixed urinary incontinence is a combination of different types of bladder dysfunction. It is usually caused by both an increase in intra-abdominal pressure and an irresistible urge to urinate. Urinary incontinence is especially common in older women.
Causes of Urinary Incontinence
Urinary incontinence can have various symptoms and occur for various reasons:
- surgical removal of the uterus;
- damage to the central nervous system associated with neuralgic diseases (Parkinson's disease, stroke, multiple sclerosis, etc.);
- infections;
- tumors and scar tissue;
- emotional disorders;
- aging process;
- certain medications such as sleeping pills, antidepressants, sedatives, narcotics, anticholinergics, etc.;
- damage to the nerves of the bladder;
- shingles, diabetes, etc.
Sometimes urinary incontinence can be caused by frequent overflow of the bladder, where the normal flow is blocked and the bladder cannot empty itself completely.
Ordinary drinks can also increase the manifestation of the disease:
- drinks with caffeine or carbonates, such as coffee, soda, tea;
- alcoholic drinks;
- smoking.
Complications of the disease
The following aspects can be attributed to the complications of the course of the disease.
Emotional aspects
Urinary incontinence in women can have serious consequences and emotional effects. The patient feels awkward and helpless. This problem interferes with social and labor activity, and its symptoms develop depression.
Disorders of daily life
People with urinary incontinence (especially if the tide is high) are forced to completely change their lifestyle and adapt to the disease.
Specific Effects
Incontinence is a particularly serious problem for the elderly. Sometimes it is one of the reasons for the loss of independence, a change in the quality of life, and even leaving home.
Treatment of the disease
There are several approaches to the treatment of the disease. But the best result is achieved if the treatment is aimed at eliminating the causes of urinary incontinence, taking into account the health status of each patient.
If any urinary incontinence in women is temporary, then it is treated simply and quickly. If the symptoms of the disease are associated with a urinary tract infection, then it can be eliminated with antibiotics.
But for chronic incontinence, long-term treatment may be required, including a number of procedures:
- women can improve the condition of Kegel exercises, the use of devices such as a pessary, adherence to a urinary schedule, lifestyle changes;
- the use of drugs, which may be anticholinergics or antidepressants;
- performing exercises aimed at training the normal functioning of the bladder.
Surgery
In the case when the therapeutic treatment of urinary incontinence does not give the desired results, women are offered surgery.
Surgical treatment always pursues one goal - to return the organs of the urinary system to their normal position. The decision to perform an operation is based on an accurate diagnosis, the ineffectiveness of therapeutic methods of treatment, and a correct understanding of the expected results of the operation.
Disease prevention
To reduce the likelihood of developing incontinence, it is necessary to prevent it. To do this, every woman must:
- Maintain a healthy weight;
- Constantly carefully train the muscles of the pelvic floor;
- Quit smoking, as smoking causes a coughing fit, which increases the symptoms of incontinence.
Memo to patients
- Incontinence is too common a disease to be ashamed of.
- There is no universal and simple cure for this disease, so it can be a combination of medical and surgical treatment.
- Such a pathology in the elderly is not the norm, and age only affects the choice of specific treatment tactics.
- Today, patients have a wide choice: use modern safe techniques or “go under the knife”. Before dwelling on something specific, you need to learn about all the treatment options.
Incontinence, or urinary incontinence, is a pathology that affects children and adults. The disease not only causes inconvenience, but also causes instability of the psycho-emotional background. A person becomes irritable, withdrawn, complexes arise. After the age of 40, urinary incontinence is more common in women than in men. To get rid of the pathology, it turns out the cause that led to the occurrence of incontinence. Only after that the doctor prescribes the appropriate therapy.
Urinary incontinence is the involuntary passage of urine that cannot be prevented by willpower. A person loses sensitivity, as a result of which the patient cannot control the process of urination. All aspects of life suffer from this - social, business and personal. The patient cannot fully work, contact with loved ones and live a normal family life.
Urinary incontinence is a symptom of another pathology, and treatment is based on the nature of the underlying disease.
Status classification
Experts classify incontinence as follows.
- stress incontinence. Sudden urination occurs with excessive physical exertion or strong tension, which occurs in the case of reflexes such as coughing, sneezing and others.
- Urgent incontinence, or overactivity of the bladder, is a problem with urination that occurs due to the pathology of the organ itself or a violation of the nervous system. Urination occurs during rest, without physical exertion. Associated symptoms are frequent urination more than eight times a day and once at night.
- Neurogenic bladder. Violation of the bladder due to a malfunction in the functioning of the nervous system.
- Infravesical obstruction, or subvesical blockage of the urinary tract. Involuntary urination due to the weakening of the walls of the bladder during its filling.
- Extraurethral incontinence. Urination occurs due to pathological communication between the organs of the reproductive and urinary systems or a congenital anomaly of the ureters. At the same time, the woman has an urge to go to the toilet, but she is unable to stop urination.
- Enuresis. In women, this condition is observed during a night's rest. Urine is passed suddenly, without the urge to go to the toilet.
- Mixed look. It combines stress and imperative incontinence. It usually occurs in women after the birth of a baby, when mechanical damage to the pelvic organs or muscles occurred during labor. Symptoms - the release of urine during the urge to the toilet or during physical exertion.
- Undermining. After visiting the toilet, urine accumulates in the urethra and when leaving the bathroom there is a residual excretion.
Causes of violation and suggestive factors
Involuntary urination in women occurs for several reasons. Usually the appearance of incontinence occurs due to pathologies and age-related changes in the body.
Climax
With menopause, there is a deficiency of female hormones - estrogens. This leads to atrophic changes in the membranes of the urinary and genital organs, muscles and ligaments located in the small pelvis.
During pregnancy and after childbirth
Pregnancy and childbirth provokes the appearance of this problem. During childbirth, an increased load is created on the pelvic organs and when the baby is born, they are injured and damaged muscles. As a result, incontinence occurs.
Elderly age
The appearance of sudden urination is affected by age. This problem occurs in women after 60 years. The muscles of the pelvis lose elasticity and cease to properly support the internal organs. With age, there is also a lack of female hormones, which also affects the appearance of urinary incontinence.
Diseases and injuries
Diseases and injuries that cause incontinence:
- urolithiasis of the bladder;
- chronic cough;
- sclerosis;
- pathology of the gastrointestinal tract;
- gynecological pathologies;
- abnormal structure of the urinary or genital organs;
- diabetes mellitus of any type;
- infections that are constantly present in the bladder;
- pathology of Parkinson's or Alzheimer's;
- prolapse of organs located in the small pelvis;
- oncological pathologies of the bladder.
Other reasons
Other causes of urinary incontinence in women:
- surgery on the pelvic organs;
- unstable emotional background;
- radiation exposure;
- large body weight;
- harmful addictions - smoking and alcohol abuse;
- taking certain medications;
- excessive consumption of coffee, sugary carbonated drinks;
- improper nutrition.
Incontinence manifests itself as follows:
- urine leakage;
- unexpected urge to urinate;
- the desire to visit the toilet arise during the hours of night rest;
- after urination there is no relief, and there is a feeling that the bladder is full;
- feeling that a foreign body is present in the vagina;
- frequent urge to go to the toilet.
Diagnostics
Before prescribing treatment for urinary incontinence, a diagnosis is made. To determine the cause of the condition, the doctor prescribes:
- urinalysis to determine the presence or absence of infections in the genitourinary system;
- PAD test to determine the amount of urine flowing suddenly;
- vaginal examination with a cough test to determine the presence or absence of gynecological pathologies;
- KUDI.
Before the tests, the doctor conducts a survey of the patient and sometimes asks to make a diary of the sudden release of urine.
How to treat urinary incontinence in women? There are several effective therapeutic methods that can only be prescribed by a doctor after a diagnosis, subject to the pathology that provoked the development of the disease. If involuntary urination occurs due to a disease, then its therapy is carried out.
With proper treatment, incontinence goes away on its own.
The use of drugs is possible if there is no anomaly in the structure of the organs of the urinary system. This is the main method of treating pathology. Medications are prescribed depending on the cause that led to the onset of incontinence.
- Drugs whose main active ingredient is estrogen. The doctor prescribes such medications for low levels of the female hormone.
- Sympathomimetics. Improve the contraction of the muscles involved in urination. The drug commonly prescribed is Ephedrine.
- Antidepressants. The doctor prescribes them if incontinence develops due to an unstable emotional background.
- Anticholinergic drugs. Promote relaxation and increase the volume of the bladder. The doctor usually prescribes Tolteradine, Driptan, Oxybutin.
- Desmopressin. The doctor prescribes such a drug for temporary incontinence. The tool reduces the amount of urine.
Operational method
Surgical intervention is resorted to if conservative methods of therapy have proven to be ineffective. There are several methods for solving the problem in an operational way.
- Sling method. The duration of the operation is half an hour. No general anesthesia is used during the procedure. Enough local anesthesia. The essence of the operation is the introduction of a special mesh, which looks like a loop, under the urethra or the neck of the bladder. It prevents involuntary urination when the pressure in the abdominal cavity increases.
- Bulk injections. The essence of the procedure is the introduction of a special substance into the urethra using a cystoscope. After such manipulation, the urethra is set in the correct position.
- Laparoscopic calposuspension. Before surgery, the patient is given general anesthesia. The essence of the procedure is that the tissues that surround the urethra are fixed on the inguinal ligaments. This prevents involuntary urination.
The essence of the exercises is reduced to the daily tension of the muscles of the small pelvis.
Manipulations are carried out in the morning, afternoon and evening. The duration of the procedure is 10 seconds. Muscle contraction must be followed by relaxation. The muscles also relax for 10 seconds, and then contract again. Only under this condition can you count on a positive effect from the procedure. Some time after the start of gymnastics, the time for muscle tension and relaxation increases.
The total duration of one session should be 20 seconds.
Folk remedies
Urinary incontinence in women can be treated with folk methods. But even in this case, you need to consult a doctor.
Infusion on dill seeds
To prepare this effective homemade recipe, you will need:
- dill seeds - 1 large spoon with a slide;
- water - 1 glass.
Water is brought to a boil, and dill seeds are poured into it. The container in which the product is prepared is insulated and left to infuse for three hours. When the time is up, the agent is filtered. The drink is consumed at one time.
The duration of therapy is not limited. It is recommended to stop taking the drug after achieving a positive result. The tool is used at any age. With a positive reception, according to unconfirmed reports, patients get rid of involuntary urination.
Decoction based on yarrow
Required components:
- dried yarrow grass - 10 g;
- water - 1 glass.
Medicinal plant is filled with water. The container is put on fire, and the product is brought to a boil. After that, the drink is brewed for another 10 minutes. The container with the broth is removed from the stove, insulated and left to infuse for 60 minutes. The medium is filtered. The frequency of admission - in the morning, afternoon and evening, 0.5 cups.
Infusion based on corn stigmas
To prepare the product you will need:
- corn stigmas - 1 large spoon;
- water - 1 glass.
Medicinal plant is poured with the specified amount of boiling water. The container is insulated and left for half an hour to infuse. The tool is used for half a glass in the morning and evening hours.
Healing Blend
Ingredients:
- honey - 1 large spoon;
- natural applesauce - 1 tablespoon;
- chopped onion to a mushy state - 1 large spoon.
All products are combined and mixed. The resulting remedy is used in the morning, afternoon and evening.
For therapy, an infusion prepared on the basis of sage is also used.
Any remedy is used only as directed by a doctor, so that there are no complications.
Prevention
To prevent the occurrence of urinary incontinence, it is recommended to adhere to the following preventive measures:
- regular visits to the therapist, endocrinologist, gynecologist;
- regular;
- proper nutrition;
- refusal of a sedentary lifestyle;
- maintaining a normal weight;
- going to the toilet immediately after the urge to urinate;
- abandoning harmful addictions.
Conclusion
If you experience the first symptoms of a condition such as urinary incontinence in women, you should consult a doctor. Timely therapy will help to avoid the progression of pathology and the development of complications. Do not self-medicate, as unexpected consequences may occur.