Urinary incontinence in women
Urinary incontinence in women is a condition in which urine flows involuntarily. Urinary incontinence is divided into overflow incontinence, anatomical incontinence, functional incontinence, and total incontinence.
In 20% of women, involuntary discharge of urine is observed at the age of 20 to 55 years, in 15% of women - up to 35 years, in 28% - after 55 years.
Symptoms and causes of urinary incontinence in women
There are two main causes of urinary incontinence. Urinary incontinence can occur when pressure is applied to the bladder while laughing, sneezing, coughing, and other activities. Stress-induced urinary incontinence does not appear during sleep or when body position changes.
The cause of urinary incontinence in women may be an uncontrollable urge to urinate, which occurs when the muscles of the bladder contract involuntarily.
Urinary incontinence can be associated with pelvic floor insufficiency. After a pelvic floor injury, the uterus, bladder and vaginal walls descend, changing their natural position. Urinary incontinence can be triggered by hereditary factors, various anatomical disorders (acquired and congenital), surgical interventions, hard work, genitourinary infections, taking certain medications, overweight.
This disease can gradually develop with stones in the bladder, with pelvic organ prolapse, diabetes mellitus, Alzheimer's or Parkinson's disease, multiple sclerosis, bladder cancer, stroke, spinal cord injury, as well as after a hysterectomy (removal of the uterus) and chronic cough associated with smoking or prolonged bronchitis.
Urinary incontinence can develop with smoking, insufficient fluid intake and excessive caffeine abuse.
Symptoms of urinary incontinence
With urinary incontinence in women, the urge to urinate is inconsistent. The symptoms of the urge can vary depending on the specific situation and lifestyle. However, with all the symptoms, there is always an uncontrollable urge to urinate. Increased urination occurs at night. With frequent urination, the patient's condition worsens, since the bladder no longer holds a large volume of urine.
The urge to urinate during urinary incontinence can occur even with an almost empty bladder. A small amount of urine flows out in a stream, in a strong stream, or in drops. Excretion of urine occurs when running, walking, in bed, with the sounds of water pouring from the tap. Neurogenic incontinence occurs when an overstretched bladder is overly distended. When the bladder fills completely, the pressure of the fluid overcomes the sphincter's resistance, and urine seeps out of the bladder. With this type of disorder, women are usually not able to urinate in a strong, even stream.
Methods for the diagnosis and treatment of urinary incontinence in women
To clarify the diagnosis of urinary incontinence in women, the doctor clarifies the details of the development of the disease and conducts a physical examination. The presence of an infection in the bladder helps to determine the culture for sterility, urinalysis and urinalysis. For a stress test on the bladder, the doctor injects fluid into the bladder and asks you to cough. And in the Bonnie test, lifting (pulling) the bladder neck occurs with an instrument or finger inserted into the vagina. The pad test helps you determine how often and how much urine is leaking during the day.
In addition, in case of urinary incontinence, the doctor may prescribe cystometry, cystometrography, uroflowmetry - a series of tests to determine the pressure in the bladder at different fullness. During cystometry, leak pressure and maximum urethral compression force are determined. The method of ultrasound diagnostics and radiography helps to determine the residual amount of fluid in the bladder after urination. They help determine the position of the urethra and bladder when straining, coughing and urinating.
Some patients are prescribed cystoscopy, a method of studying the internal structure of the bladder and urethra using a thin endoscope. A cystourethrogram helps to identify physical defects of the urinary system. In this method, iodine-containing contrast is used to obtain an X-ray image of the inner walls of the urethra and bladder.
There are many approaches to the treatment of urinary incontinence in women. The best therapy is based on combating the cause of urinary incontinence. And depending on the cause of the disorder, physiotherapy, exercise, hormonal therapy, drug therapy, psychotherapy or surgical therapy are used. Well-being can be improved by replacing one medication for urinary incontinence in women with another, while eliminating the pathological condition underlying the disorder.
Kegel exercises can help with any type of urinary incontinence in women. These exercises help to strengthen the muscles of the abdomen and pelvis. When performing the exercises, the patients should contract the pelvic muscles three times a day for three seconds. The effectiveness of the use of pessaries, special intravaginal rubber devices largely depends on the type of incontinence and the individual characteristics of the anatomical structure of the body.
It is quite possible to strengthen the pelvic muscles using extracorporeal magnetic stimulation. During this procedure, a magnetic field acts on the nerve endings of the body.
Stress urinary incontinence, but without weakening the pelvic floor muscles, vaginal atrophy is treated with various drugs (for example, the decongestant and decongestant Zyudafed). Certain medications for urinary incontinence in women are believed to provide a lifelong treatment effect.
If urinary incontinence is caused by prolapse or prolapse of the uterus, then surgical intervention is indispensable. Surgery for urinary incontinence in women can also eliminate fistulas that can cause incontinence.
Surgery for urinary incontinence in women is performed either by transvaginal or transperitoneal access under general anesthesia. In extremely severe cases, incontinence is treated with an enlarged bladder or urinary diversion.
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The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
