About incontinence
According to the modern classification for urinary disorder, urinary incontinence is referred to as a type of stress incontinence. Involuntary discharge of urine from the bladder occurs as a result of an urgent and uncontrollable urge to urinate (unlike other types of urinary incontinence, in which urine is excreted involuntarily without urge).
Urinary incontinence can be caused by a pathological process of the bladder., in particular with the defeat of his neck. This ailment is caused, first of all, by inflammatory diseases (acute and chronic cystitis, bladder tuberculosis), stones and tumors of the bladder, adenoma and prostate cancer.
With such diseases, the physiological capacity of the bladder decreases, which lowers its irritation threshold. Even a small amount of accumulated urine in the bladder can cause such strong spasmodic contractions that the patient is unable to hold urine.
Incontinence in men and women
Urinary incontinence in women and men is considered one of the most common urological diseases in the world. Incontinence affects over 200 million people worldwide. In the United States of America alone, urinary incontinence in men, as a chronic condition, affects 12 million people.
Urinary incontinence in both men and women is one of the major problems among the elderly. The incidence of urinary incontinence in men depends on the age group and can range from 4% at the age of 40-65 to 25% in men at the age of 75.
Despite the fact that urinary incontinence in men is not considered a life-threatening disease, it significantly reduces a person's capabilities, reducing the quality of life and creating unpleasant problems for the people around them. Such unpleasant problems include persistent unpleasant odors, the need to use diapers or pads. The inability to be absent for a long time (or even to leave the house for a while) leads to social maladjustment and mental and emotional disorders, and in the future to self-isolation and forced isolation.
Urinary incontinence in women is a painful disease, and due to constant irrigation with urine of the skin of the thighs and external genitalia, painful maceration and pyoderma are caused.
The disease seriously reduces the ability to work in women, having a depressing effect on their psyche.
Urinary incontinence in women occurs due to dysfunction of the sphincter and fixing systems of the bladder with symptoms such as coughing, sneezing, heavy lifting, and actions that increase intra-abdominal pressure.
Various reasons determine the appearance of functional urinary incontinence in women:
- Birth trauma;
- Surgical trauma of the urethra;
- Heavy physical activity, which leads to prolapse and prolapse of the pelvic organs;
- Congenital underdevelopment of the muscles of the bladder;
- Endocrine Disorders.
Having established the reasons that caused urinary incontinence for each of the patients, an indication for effective treatment is determined in order to eliminate the changes that have appeared.
Treatment of urinary incontinence in women
Our specialist doctors use the following methods for the treatment of urinary incontinence in women and men:
Conservative treatment
Perhaps in the case of urgent urinary incontinence in women, that is, when there is an overactive bladder. Same way conservative treatment can be prescribed for patients with a mixed form of urinary incontinence, when, along with the insufficiency of the locking mechanism in the urethra, there is an urgent component, that is, overactive detrusor (muscular membrane of the bladder). In the case of urgent incontinence, treatment consists in the constant intake of m-anticholinergics (vesicar, detrusitol). In the mixed form, these drugs are usually prescribed before and after surgery for correcting urinary incontinence (sling urethropexy, TVT, TVT-o), after the surgery, the drugs are canceled.
Botulinum toxin injections
The method of injection of botulinum toxin type "A" into the detrusor of the bladder is used to treat urge incontinence, that is, urinary incontinence in women, which occurs against the background of overactive detrusor (overactive bladder). In urology, the drug manufactured in China "Lantox" is used, transurethrally (using a cystoscope) into the wall of the bladder, 200-300 U of the drug "Lantox" is usually injected.
Surgical treatment of urinary incontinence
TVT operation, TVT-o operation (for women). The method is used for stress urinary incontinence (stress urinary incontinence, exercise, coughing, laughing, sneezing) or mixed urinary incontinence (stress component + detrusor overactivity). The operation is minimally invasive, its essence lies in the fact that under the proximal (located closer to the bladder) urethra a special synthetic loop is carried out, which subsequently "overgrows" with connective tissue and turns into an artificially created ligament that holds the urethra in a normal anatomical position (there, where it should normally be) and thereby prevents the occurrence of urinary incontinence.
More than half of women experience urinary incontinence at least once. Sometimes it occurs in young girls after childbirth, sometimes it causes inconvenience to the elderly, and some accompanies some for a long time.
Fear of passing urine can lead to psychological, sexual disorders, depression and hinder personal and career growth. Incotinence (another name for incontinence) always reduces the quality of life, and therefore requires special attention.
There is even a special international organization for urinary retention that conducts research and develops all kinds of treatments. Experts call urinary incontinence any involuntary discharge. But depending on the conditions, time of day, circumstances of incontinence, there are several types of it.
Types of urinary incontinence
- stressful
- imperative (urgent)
- mixed
- other types (continuous urinary leakage, bedwetting, unconscious incontinence)
- iatrogenic incontinence (due to medication)
The first three types are found most often and are typical for women.
Stress urinary incontinence
This type of incontinence accounts for half of all cases of uncontrolled urination. The main reason for this condition is the malfunction of a special muscle - the sphincter of the urethra. The weakening of this muscle, together with a periodic increase in intra-abdominal pressure, lead to urine leakage or even complete emptying of the bladder.
Symptoms of stress urinary incontinence
- leakage of urine in varying amounts during exercise, laughing, coughing, intercourse, straining
- lack of irresistible urge to urinate
- sometimes - a combination with incontinence of gases and feces
There are many reasons why stress urinary incontinence can occur.
- Pregnancy
Almost all women in interesting positions are uncomfortable with a small amount of urine leaking. They are forced to plan their walks based on the location of the toilets. Moreover, in the first weeks of pregnancy and shortly before childbirth, the symptoms of incontinence are more pronounced. This is due to the altered hormonal background and the pressure of the uterus on the pelvic organs.
Especially often, incontinence occurs after spontaneous childbirth with a large fetus with a perineal incision and other manipulations. As a result, the muscles and ligaments of the pelvic floor are damaged, intra-abdominal pressure is unevenly distributed and the sphincter ceases to perform its function. It is after ruptures or inaccurate incisions of the perineum (episiotomy) that incontinence of gases and feces joins the urinary incontinence.
- Operations on the pelvic organs
Any interventions related to the uterus, bladder, rectum, cause adhesions and changes in pressure in the small pelvis. In addition, operations are sometimes complicated by fistulas between organs, which also leads to urinary incontinence.
- Age-related changes
With age, the elasticity of the ligaments and muscle tone decreases, which inevitably leads to dysfunction of the sphincter. After the onset of menopause, the body experiences an estrogen deficiency, which is the cause of urinary incontinence in older women.
In addition to these root causes, there are risk factors. They can be a background for the development of urinary incontinence, but their presence does not necessarily lead to this disease.
Risk factors
- Caucasoid race
- heredity (in the presence of the disease in close relatives or cases of bedwetting in childhood, the risk of incontinence is greater)
- obesity (especially in combination with diabetes mellitus)
- neurological diseases (stroke, heart attack, parkinsonism, spinal injury)
- urinary tract infection
- digestive disorders
- taking some medications
- anemia
Stress urinary incontinence gives women a lot of trouble. Refusal to play sports, fear of losing urine in public, constant nervous tension negatively affect health. Therefore, it is important not to be shy and not hush up this topic, but to see a doctor in time.
Urge incontinence
Normally, the urge to urinate appears after a certain amount of urine has accumulated in the bladder. Feeling this urge, a woman can successfully restrain him to the nearest toilet room. With increased bladder reactivity, even a small amount of urine is enough to create a strong, intolerable urge. And if, by a lucky chance, there is no toilet nearby, then there is a risk of missing urine.
The cause of this ailment is believed to be a hyperreactive bladder. Due to the special mobility of the psyche and the speed of nerve impulses, the muscles of the sphincter and bladder react to the slightest irritation. Therefore, urine can be missed if it accumulates a little in the bladder, especially if there is any external stimulus (bright light, the sound of pouring water, etc.)
The main symptoms of urge incontinence
- frequent urge to urinate
- the urge is almost always sudden
- an irrepressible desire to urinate
- the onset of the urge is often provoked by external circumstances
The risk factors for urge incontinence are the same as for stress incontinence because the two are often combined.
Differential diagnosis of urinary incontinence
Iatrogenic incontinence
Some drugs on the list of their side effects have urinary disorders:
- adrenergic agonists (pseudoephedrine) can cause urinary retention with subsequent incontinence, are used to treat bronchial diseases;
- all diuretics;
- colchicine (to treat gout);
- some estrogen medications;
- sedatives and
After you stop taking these drugs, the unpleasant symptoms go away by themselves.
Other types of incontinence
More rare causes of urinary loss are usually associated with organic pathology. It can be damage to the brain and spinal cord as a result of tumor processes, trauma, strokes, multiple sclerosis.
Only a doctor can determine the exact cause of the problem. Usually, for incontinence, women turn to gynecologists and urologists. Recently, a narrow specialty has appeared - urogynecology, which deals with issues of the female genitourinary sphere.
Examination for urinary incontinence
A detailed story about complaints to the doctor
The factors that provoke incontinence, the time of onset of symptoms, their severity, additional complaints are important. In addition, you need to ask your mother, grandmother, sisters about similar symptoms in order to identify a hereditary predisposition. Be sure to note if there were cases of chronic nocturnal enuresis in childhood.
You can fill out a questionnaire designed specifically for people with incontinence. Incontinence Symptom Questionnaire (ISQ):
1. How long have you been experiencing symptoms of incontinence?
2. Has the volume of urine passed changed since the onset of the disease?
3. How has the incidence of urinary incontinence changed since their onset?
4. Indicate how often (never, sometimes, often) incontinence occurs when following the steps below.
- physical exercise, including running, sports
- sneezing
- cough
- lifting weights
- change in body position: transition from a seated to an upright position
- the sight or sound of bubbling water
- psycho-emotional stress
- hypothermia
5. Do you have an irresistible urge to urinate?
6. How long can you hold on to urine when the urge appears?
7. How often do you lose urine?
8. When is urinary incontinence more common?
9. Do you feel the laundry getting wet without the urge to urinate?
10. Do you wake up at night to urinate?
11. Please indicate how much urine you usually lose.
12. Rate on a 5-point scale the degree to which urinary incontinence affects your daily life: _____ (0 - no effect, 5 - significant).
Keeping a voiding diary
Detailed records of urination and incontinence cases will help your doctor diagnose and treat you correctly.
| Time | What liquid did you take and how much? (water, coffee, juice, beer, etc.) | How many times did you urinate in one hour? | How much urine? (a little, medium, a lot) or specify in ml | Experienced Are you an intolerable urge to urinate? |
Have you had an episode of involuntary urination? | How much urine was passed during this episode? (a little, medium, a lot) or specify in ml | What were you doing during the involuntary discharge of urine? |
| 7:00 -8:00 | Tea, 200ml | 1 | A little | — | — | — | — |
| 8:00 -9:00 | — | 1 | A little | Yes | Yes | Little | Did my morning run |
| 9:00 –10:00 | |||||||
| 10:00 -11:00 |
PAD test
Often, the concepts of "a lot" and "a little" differ from woman to woman, so it is difficult to assess the degree of the disease. This is where the pad test, or PAD test, comes to the aid of doctors. This method is used to obtain objective data on the amount of urine passed.
For examination, a woman should wear urological pads, weighing them before and after use. The duration of the test can vary from 20 minutes to two days, more often about 2 hours. When performing the short test, it is recommended to drink half a liter of still water.
Vaginal examination
Examination of the genitals with gynecological mirrors is necessary to exclude other diseases. During the examination, the doctor may find:
- atrophy of the vaginal mucosa. After menopause, dry genitals associated with estrogen deficiency can worsen urinary incontinence
- prolapse or prolapse of the pelvic organs (see)
- large fistulas
On examination, a cough test is performed: when coughing, you can notice the discharge of urine from the urethra.
Analysis of urine
Very often, with inflammatory changes in the organs of the genitourinary system, incontinence of small portions of urine occurs. Therefore, the detection of leukocytes, erythrocytes or bacteria in the urine gives rise to an examination for infections. To get an accurate result, you need to know the basic rules for collecting urine:
- use the first, "morning" urine
- collecting a midstream urine
- conduct a thorough toilet of the vagina before urinating
- cover the vagina with a clean cloth during collection
Imaging (ultrasound, MRI)
Urodynamic studies (to determine the type of incontinence)
Treatment of urinary incontinence
Depending on the cause of urinary incontinence in women, treatment is carried out by gynecologists, urologists in the clinic or surgeons in the hospital.
- general treatments
- stress incontinence treatment
- urinary incontinence treatment
Therapy for any type of urinary incontinence should be started with the simplest and most affordable methods. Such methods include lifestyle adjustments and special exercises. This is a lifestyle correction:
|
a necessary step in the treatment of all types of urinary incontinence. Extra pounds constantly increase intra-abdominal pressure, disrupt the normal arrangement of organs, causing urination disorders. Depending on the degree of obesity, psychological, medical or surgical treatment is used. |
|
Caffeinated drinks provoke frequent urination, so the risk of passing urine increases significantly. But excessive restriction of fluid intake is also undesirable: incontinence will not reduce it, but it will negatively affect overall well-being. |
|
A huge number of studies have been carried out to identify a direct link between tobacco smoking and incontinence, but the topic remains unexplored. We can only say with certainty that chronic nicotine bronchitis with stress urinary incontinence is a huge problem, since with every coughing movement, a woman drops urine. The treatment of chronic respiratory diseases can also be attributed to this point. |
|
This method gives very good results for urge incontinence. Its essence lies in visiting the toilet at strictly defined hours, regardless of the strength of the urge. At first, the intervals between urination do not exceed 30-60 minutes, but over time, you can develop a more comfortable regimen. |
|
The main purpose of this training is to tone the muscles, restore the sphincter function and regulate the phases of filling and urination. With the help of special exercises and devices, a woman can completely take control of the sphincter muscles, eliminating the sudden loss of urine. |
|
|
Kegel exercises
The essence of such gymnastics is as simple as possible. First, you need to "find" the desired pelvic floor muscles: perivaginal and periurethral. To this end, you need to while sitting, imagine the urge to urinate and try to keep this imaginary stream of urine. The muscles involved in this process need to be exercised regularly.
Three times a day, make them contract and relax, gradually increasing the time for performing the contractions from a few seconds to 2-3 minutes. This process will be invisible to others, so you can practice not only at home, but also at work, driving in a traffic jam and at any free time.
After gaining control over the muscles at rest, the task can be complicated: trying to contract them when coughing, sneezing, and other provoking factors. You can diversify and manipulate the muscles to achieve the best effect.
- slow compressions
- rapid contractions
- pushing out (by analogy with the forced labor period)
- delay of the stream during real urination
Biofeedback training
The main disadvantage of simple Kegel exercises is the inability to control their implementation. Sometimes women, along with the necessary muscles, strain others, which increase intra-abdominal pressure. Not only does this negate the entire workout, but it can also make the problem worse.
A set of exercises with biofeedback (BFB) includes a special apparatus for recording muscle tone. With its help, you can control the correctness of the contractions, and, if necessary, perform electrical stimulation. Biofeedback training has been proven to improve muscle tone and urinary control.
Contraindications to biofeedback training:
- inflammatory diseases in the acute phase
- severe diseases of the heart, kidneys, liver
Use of special simulators
For training, many compact devices have been created that allow you to strengthen the muscles of the pelvic floor with maximum efficiency and perform all the exercises necessary for urinary incontinence in women.
One of these simulators is the PelvicToner. This device, based on the properties of a spring, allows you to gradually and correctly increase the load on the intimate muscles, strengthening them. It is easy to use and maintain and has been clinically proven to work.
Psychological training
If you have a strong urge to urinate, you can try to distract yourself from the thought of it. Everyone has their own ways: think about plans for the day, read an interesting book, take a nap. The main task is to make the brain forget about going to the toilet, at least for a short period.
Treating stress incontinence
In addition to the general methods for managing incontinence described above, the treatment of stress incontinence requires the intervention of a physician. Conservative treatment with drugs is not very popular, as it helps only in a small number of cases.
Drug treatment:
With a mild degree of stress incontinence, when the anatomical structures have retained their integrity, it is sometimes used:
- Adrenomimetics (Gutron) increase the tone of the sphincter and urethra, but they also act on the tone of the vessels. Used extremely rarely due to low efficiency and side effects (increased blood pressure)
- Anticholinesterase drugs (Ubretide) also increase muscle tone. Recommended for women who have bladder hypotension based on examination results.
- Antidepressant Duloxetine (Simbalta), effective in half of the cases, but with side effects on the digestive system.
Treatment of stress incontinence with pills is very rare because of frequent relapses and side effects.
Operative treatment
For stress urinary incontinence in women, surgery is the treatment of choice. There are several surgical procedures that differ in the complexity of their execution. The preference for one or another operation is given depending on the degree of incontinence and the anatomical features of the woman's urethra.
Contraindications to all types of surgical treatment are:
- malignant neoplasms
- inflammatory diseases of the pelvic organs in the acute phase
- diabetes mellitus in the phase of decompensation
- diseases of the blood coagulation system
Sling operations (TVT and TVT-O)
These interventions are minimally invasive, last about 30 minutes, and are performed under local anesthesia. The essence of the intervention is extremely simple: the introduction of a special synthetic mesh in the form of a loop under the bladder neck or urethra.
This loop keeps the urethra in a physiological position, preventing urine from flowing out when intra-abdominal pressure rises.
For the introduction of this mesh, one or several small incisions are made in the vagina or inguinal folds; they do not form a cosmetic defect. Over time, the mesh grows into the connective tissue, firmly fixing the urethra.
Recovery after such operations occurs very quickly, the effect is felt almost immediately. Despite the attractiveness of sling operations, the likelihood of relapse still remains. In addition, with detrusor instability and anatomical defects of the urethra, this surgical intervention may be ineffective.
Despite the difficulties described above, minimally invasive loop surgery is the gold standard in the treatment of stress incontinence.
Bulking agent injections 
During the procedure, under the control of a cystoscope, a special substance is injected into the submucosa of the urethra. Most often it is a synthetic material that does not cause allergies.
As a result, the missing soft tissues are replaced and the urethra is fixed in the desired position. The procedure is low-traumatic, carried out on an outpatient basis under local anesthesia, but also does not exclude relapses.
Laparoscopic colposuspension according to Burch 
The operation is performed under general anesthesia, usually by laparoscopic access. The tissues around the urethra are suspended from the inguinal ligaments. These ligaments are very strong, so the long-term results of the operation are very convincing.
But due to the type of anesthesia and the complexity of the procedure, colposuspension has more contraindications and complications than sling operations. Usually, such an intervention is carried out after an inconsistent loop procedure or in case of violations of the anatomical structure of the genitourinary apparatus.
Colporrhaphy
Suturing of the vagina with special absorbable sutures, used for prolapse of the pelvic organs. The operation has a number of complications (tissue scarring, for example) and loses its effect after a few years.
Treatment of imperative incontinence
Unlike stress incontinence, surgical treatment is ineffective for urgency. All women with such a problem are primarily advised to try general methods of treatment (non-drug). Only if they are ineffective can you think about drug therapy.
Drug treatment
In the treatment of urgent urinary incontinence in women, tablets are very effective. There are several classes of drugs, the main task of which is to restore normal nervous regulation of urination.
- Drugs that reduce the tone of the bladder wall reduce the strength and frequency of bladder contractions. The most common medicines: Driptan, Detrusitol, Spazmex, Vesicar.
- Drugs that relax the bladder in the filling phase and improve its blood circulation: Dalfaz, Kaldura, Omnik.
- In case of incontinence in women of climacteric age, when there is a deficiency of estrogen, hormone replacement therapy or special ointments are used. An example of such an ointment is Ovestin, a cream containing an estrogen component. Its use can reduce dryness and itching of the mucous membranes, reducing the frequency of urinary incontinence.
Treatment of urinary incontinence in women is a complex task that requires an integrated approach and strict implementation of all the recommendations of a specialist. A few simple rules will allow you to avoid or delay the manifestations of this ailment as much as possible.
Prevention of urinary incontinence
- Maintain the body's water balance. To do this, you need to drink 1.5-2 liters of still water a day. Excessive and insufficient drinking can be harmful to health.
- Try to create your own urination regimen. It's possible to train yourself to empty your bladder at a specific time. For example, in the morning before getting ready for work, during the lunch break, immediately after coming home to go to the toilet and reinforce this habit.
- Fight excess weight (on your own or with the help of a specialist)
- To refuse from bad habits
- Cut back on caffeinated foods and saltiness
- Combat constipation, if any. To do this, you can eat foods rich in fiber (vegetables, fruits, especially prunes, figs), drink enough liquid, drink half a glass of kefir at night. For chronic constipation, herbal laxatives can be used (after consulting a doctor (see)
- Strengthen the pelvic floor muscles before planning pregnancy, which will avoid perineal tears during labor
- Enjoy life and stay positive
Main conclusions:
- Urinary incontinence is a very common problem among women.
- Without treatment, urinary problems are unlikely to go away on their own.
- To find out the type of incontinence, you need to undergo an examination, including filling out a questionnaire and keeping a urination diary.
- Stress incontinence is treated with surgery and urgency incontinence with medication.
- You can do your own work to prevent incontinence by leading a healthy lifestyle and strengthening your pelvic floor muscles
Urinary incontinence is a serious problem that requires treatment. It is better to spend a little time going to the doctor and fixing it than being shy and tormented all your life.
Urinary incontinence is the involuntary discharge of portions of urine that cannot be controlled.
Urinary incontinence can be primary (with congenital anomalies in the structure of the urinary tract) and secondary (occurs due to the presence of any disease).
Urinary incontinence in women is somewhat more common than in men (according to statistics, it is present in 38% of women). The reason for this condition in them may be a complication after a difficult birth, trauma to the pelvic organs as a result of previous surgeries, heavy physical work, sexually transmitted diseases, hormonal disorders, etc.
Urinary incontinence in men can be triggered by prostate adenoma or the consequences of surgical interventions, pathology of the nervous system, the presence of stones in the bladder cavity.
Regardless of gender, causes of urinary incontinence can include:
- stress or excessive sensitivity of the nervous system;
- severe oxygen starvation of the brain;
- severe infectious diseases;
- inflammatory processes of the pelvic organs;
- pathologically sound sleep.
Urinary incontinence in children
There are frequent cases of urinary incontinence in children. The most common cause of bedwetting in them is hypothermia, stressful situations, acute respiratory viral infections and prolonged wearing of diapers (more than 2 years).
In addition, urinary incontinence is inherited. So, if one of the parents suffered from enuresis in childhood, then the probability of a pathology in a child will be 50%, since autosomal dominant genes are responsible for the occurrence of this pathology.
If urinary incontinence occurs in a child 5 years old or older, then his parents should urgently consult a doctor, since at this age the pathology can cause strong feelings and depression. Urinary incontinence in adolescence often becomes the cause of pathological changes in the psyche.
It is worth saying that many parents in vain sound the alarm, thinking that the child has enuresis, while the baby is still too young and he lacks the consciousness of actions.
Classification of urinary incontinence
At the moment, doctors distinguish the following types of urinary incontinence (regardless of whether it is primary or secondary):
- Daytime - manifests itself in the daytime. It is quite rare, and it takes a lot of effort to eliminate it: both on the part of the doctor and on the part of the patient.
- Nighttime - manifests itself during the patient's sleep. This is the most common type of pathology in young children, although adults are not so rarely faced with it.
- Mixed type - urination can occur at any time, regardless of the environment in which the person is.
Depending on the symptomatology, experts identify the following forms of urinary incontinence:
- monosymptomatic - in addition to urinary incontinence, the patient no longer bothers;
- polysymptomatic - urinary incontinence is combined with signs of urological, psychological, infectious, inflammatory and other diseases.
Unfortunately, most patients are embarrassed to consult a doctor with this problem, and try to eliminate the pathology on their own. As a rule, this does not work, and sometimes it further exacerbates the problem.
In order to get rid of the disease, patients should see a doctor. Only he, after a comprehensive examination, will identify the exact cause of urinary incontinence and, based on it, will prescribe the most correct and effective treatment.
Urologists are engaged in the treatment of enuresis, however, in some cases, the help of a neurologist, psychiatrist, gynecologist, proctologist, surgeon, endocrinologist and venereologist may be needed.
The information is for reference only and is not a guide to action. Do not self-medicate. At the first symptoms of the disease, see your doctor.
Urinary incontinence I
Urinary incontinence
Relative N. of m is manifested by the release of small portions of urine when coughing, brisk walking or physical exertion: more often occurs in women after difficult childbirth. It can also be associated with diseases of the nervous system. In the treatment of this form of N. of m, along with other methods, exercise therapy is used. The set of exercises is selected taking into account the age and general condition of the patient. Night N. m. () Is manifested by involuntary urination during sleep; observed, as a rule, in childhood and, less often, in adults. Its reasons are manifold. It can be a consequence of congenital underdevelopment of the bladder, general physical underdevelopment of the child, phimosis, cystitis and other diseases of the genitourinary system. Sometimes it occurs in children due to functional and organic (, inflammation) changes in the central nervous system. To prevent nighttime N. of m, it is very important to develop voluntary urination in the child from early childhood. It is imperative to make him urinate before bed and wake him up at night. Drinking plenty of fluids in the evening and especially at night is not recommended. With age (at 12-16 years old) night N. of m usually stops. However, given the variety of causes of night N. of m, one should find out its nature as soon as possible and carry out treatment. To prevent irritation of urine on the skin, use a urine collection bag. It should be distinguished from urinary incontinence, which occurs with an imperative, or urgent, urge to urinate. This condition is associated with severe irritation of the bladder due to cystitis, prostate adenoma, urolithiasis, and others. It stops after the disease that caused it is cured. involuntary discharge of urine from the urethra without urge to urinate. Urinary incontinence, absolute(i. urinae absoluta) - constant N. m., in which urine does not accumulate in the bladder: due to total epispadias or exstrophy of the bladder. Urinary incontinence, relative(i. urinae relativa) - N. m., in which urine is partially retained in the bladder; observed, for example, with incomplete epispadias, after the bladder in childbirth. 1. Small medical encyclopedia. - M .: Medical encyclopedia. 1991-96 2. First aid. - M .: Great Russian Encyclopedia. 1994 3. Encyclopedic Dictionary of Medical Terms. - M .: Soviet encyclopedia. - 1982-1984.
See what "urinary incontinence" is in other dictionaries:
One of the most common urological diseases in women is urinary incontinence, a condition that has an extremely negative effect on the quality of life of patients. According to domestic studies, about 38.6% of the female population ... ... Wikipedia
URINARY INCONTINENCE- - involuntary leakage of urine from the urethra (true incontinence) or from unnatural openings in the urinary tract (false incontinence). Bedwetting, involuntary urination during sleep (enuresis) occurs ... ... Encyclopedic Dictionary of Psychology and Pedagogy
Involuntary discharge of urine from the urethra without urge to urinate. It occurs in many diseases of the urinary and reproductive system of men and women of different ages. Incontinence should be distinguished from incontinence when ... Sexological encyclopedia
URINARY INCONTINENCE- See also NIGHT WITHDRAWAL in Sec. SURGICAL DISEASES, 3x, 3 and bvr urinary incontinence after childbirth, traumas. Atropinum sulfuricum, 3, 6 and bvr urinary incontinence, urine is excreted drop by drop. The bladder area is sensitive. Argentum ... ... A guide to homeopathy
Involuntary discharge of urine. There are the following types of urinary incontinence: complete urinary incontinence; urinary excretion unrelated to other phenomena; incontinence of urine inability to delay urination after the onset of a feeling of urinary fullness ... ... Medical terms
- (honey) a painful condition, in a broad sense, indicating the impossibility of keeping urine in the bladder, is characteristic mainly, but not exclusively, of childhood (2-13 years old) when the patient urinates under him in bed. The reasons for this ... ... Encyclopedic Dictionary of F.A. Brockhaus and I.A. Efron
- (incontinentia urinae; synonym anischuria) involuntary discharge of urine from the urethra without urge to urinate ... Comprehensive Medical Dictionary
urinary incontinence- honey. Involuntary flow of urine in the absence of the urge to urinate ... Dictionary of many expressions
Urinary incontinence- The mechanisms of symptom formation are the same as for fecal incontinence, and, accordingly, the same division into primary and secondary N.m. (Buyanov M.I., 1985). Primary N.m. always caused by dysontogenesis, hereditary or residually organic, ... ... Explanatory Dictionary of Psychiatric Terms
ICD 10 R32.32. ICD 9 788.3788.3 DiseasesDB ... Wikipedia
Books
- Urinary incontinence in women. Modern possibilities of conservative and surgical treatment, Rusina Elena Ivanovna, Tsypurdeeva Anna Alekseevna, Tsuladze Lilya Karlovna. The manual highlights modern approaches to therapy and surgical treatment of various forms of urinary incontinence in women. The main methods of conservative therapy and surgical correction are presented. ...
The reasons for the development of urinary incontinence. Directions of disease treatment. How can you cope with folk remedies?
Urinary incontinence is a disease in which it is not always possible to control the process of urination. This disease, at first glance, does not have physiological consequences, but it definitely does not allow you to feel comfortable and leads to the development of psychological problems against the background of constant thoughts about possible unpleasant odors that other people may smell, therefore it is necessary to treat it. In practice, pathology develops in women aged 50–70 years and has the following statistics:
- 5-15% of the total adult population;
- 20-30% of the number of hospitalized;
- up to 70% of those in a nursing home.
The causes of urinary incontinence
The problem may be due to the following factors:
- surgical interventions;
- difficult childbirth;
- taking a number of medicines;
- hormonal disruptions (lack of estrogen);
- transferred;
- pregnancy;
- changes in the central nervous system and so on.
The direct cause of incontinence is excessive pressure on the bladder, muscle weakness or a problem with their control for objective reasons.
Urinary incontinence can occur in the presence of a number of serious diseases and their treatment. We are talking, for example, about the introduction of a catheter, sepsis, cystitis or bedsores. Also, the reason may be the use of a number of drugs. In any case, when you get rid of the underlying disease or stop taking medications, urinary incontinence automatically disappears.
Symptoms of urinary incontinence in women
The following factors indicate pathology:
- sensation of a foreign body in the vagina;
- digging in urine after using the toilet;
- leakage of urine;
- regular urge at night;
- the appearance of urine with more or less severe physical exertion, with coughing, sneezing or laughing.
Types of urinary incontinence
The disease is divided into two main groups:
- stressful;
- urgent.
The first refers to the involuntary uncontrolled urination that occurs when the pressure from the abdominal cavity rises. Most often, urinary incontinence is observed here when lifting weights, coughing, sneezing, and at the same time there is no urge.
Urgent urinary incontinence refers to the uncontrolled flow of urine, which is necessarily accompanied by strong urge. The latter occur even if the bladder is not full, and it is not possible to stop urination.
How to quickly treat urinary incontinence in women (enuresis) at home
To get rid of the problem, it is necessary to correctly identify the cause of the development of pathology. With an urgent type of urinary incontinence, medications are usually prescribed to quickly cope with the disease. Usually, doctors prescribe antispasmodics, antidepressants, and hormonal medications. The stressful appearance of being unable to control urine output can be dealt with on your own. Treatment in the latter case is carried out by the following methods:
- exercises for intimate muscles;
- training directly the bladder;
- physiotherapy procedures.
Gymnastics of intimate muscles
This is a great way to strengthen the muscles of the intimate area, which will further improve the blood supply to the reproductive system, give more pleasure from intimacy, and help you reach orgasm faster. First, you need to find the muscles that are responsible for urinating and blocking the exit of urine from the bladder. To do this, interrupt it and remember the feelings, which will then need to be repeated.
Kegel exercises, which involve tenfold tension of the intimate muscles and pulling them inward, will help to achieve the desired result and get rid of urinary incontinence. You need to strain them for 10 seconds, followed by a similar relaxation in time. It is advisable to do exercises to combat enuresis in the morning and in the evening after emptying the bladder in one of the following positions:
- lying on your back, legs relaxed and bent at the knees, one hand under the buttocks, and the other under the head;
- lying on his stomach, hands under his head, under the pelvis a small pillow, straight legs apart.
Please note that when doing urinary incontinence exercises, breathing should be even and calm, and should not be drawn in the stomach.
Bladder training
This method of dealing with bedwetting (urinary incontinence) is more difficult and time-consuming. Its essence is a gradual increase in the time between trips to the toilet. To do this, it is advisable to draw up a plan in advance and gradually increase the intervals along it. This will allow you to better restrain impulses by training the corresponding muscles, but there are nuances associated with fluctuations in the volume of fluid you drink and, accordingly, the amount of urine generated in the body.
Physiotherapy for urinary incontinence
Usually prescribed by a doctor and carried out in parallel with taking medications. Depending on the situation, electrophoresis, galvanic current or electromyostimulation can be prescribed.
Folk remedies for urinary incontinence in women
Today, there is a fairly large number of folk recipes for the treatment of urinary incontinence. They have proven to be effective, but pay attention to the following factors when using them:
- consider whether you have any allergies or intolerances to the components of traditional recipes;
- in the absence of proper results or the rapid recurrence of problems with urinary incontinence, consult a doctor for professional help;
- before using folk remedies for treatment, be sure to consult with your doctor (this is especially true if you have any chronic diseases).
Folk recipes for combating urinary incontinence in women are herbal preparations containing special elements that have a beneficial effect on health and relieve unpleasant manifestations. You can buy these fees in specialized departments of pharmacies and stores, but you can also prepare yourself by collecting the necessary plants in the season and drying them correctly (we recommend collecting medicinal plants in ecologically clean areas away from roads).
Herbal tea with nettle
- May nettle (100 g);
- marshmallow root (100 g);
- yarrow herb (70 g).
The collection for combating urinary incontinence must be poured with boiling water at the rate of half a liter of water for two tablespoons of the dry mixture (it is preferable to use a thermos to slow the temperature drop and ensure that the maximum of useful substances is extracted from the leaves). The prepared solution is filtered 6–8 hours after steaming and taken in small portions throughout the day.
Herbal collection with chicory
- centaury root;
- yarrow root:
- chicory root.
Take three components in equal volumes and mix. Two tablespoons of the product are steamed with half a liter of boiling water and infused for an hour. To obtain the proper effect in the fight against urinary incontinence, drink half a glass of the finished infusion. You can repeat the procedure up to six times daily.
Rosehip decoction
Take 4 tablespoons of rose hips and one spoonful of drupes. Pour the mixture with a liter of water and cook over low heat for 30 minutes. Then add two tablespoons of rosehip flowers to the broth and wait until it boils again. The resulting infusion is filtered after cooling, and for treatment is taken twice a day, 150-200 milliliters. Note that this broth has a general beneficial effect on the body, and not only fights urinary incontinence. As a result, the infusion will help in maintaining immunity and improve well-being.
Decoction of bay leaves
Take 3-4 leaves and boil them in a glass of water for 15 minutes. Then the broth is cooled and used for a week, 100 milliliters three times a day. After a few days, you will notice an improvement in the condition, since the substances contained in the bay leaf are good at fighting urinary incontinence.
St. John's wort decoction
Pour 50 grams of dried herbs with a liter of boiling water and leave for four hours. You can drink it without any restrictions during the day.
Plantain leaf decoction
Pour boiling water over fresh leaves and leave for an hour. After straining the finished infusion, drink half a glass before meals four times a day for two weeks.
How else can you deal with pathology at home
Another way to combat urinary incontinence in women is to normalize their lifestyle. This will reduce symptoms and be an excellent prevention option when the disease either does not occur or appears much later. To do this, adhere to the following rules:
- normalize the amount of water consumed during the day (you cannot reduce the volume of fluid due to dehydration of the body and irritation of the urinary tract due to increased concentration);
- quit smoking;
- increase physical activity (at least try to take 10,000 steps daily);
- Reduce the amount of citrus fruits, coffee, sweets, spices, spicy foods and tomatoes consumed that irritate the bladder;
- normalize your weight (obese people have weaker pelvic muscles, which makes it difficult to retain urine);
- observe intimate hygiene, which will prevent infection of the genitourinary system and the development of diseases.
Another cause of urinary incontinence is constipation when the intestines press on the bladder. To level this factor at home, adhere to the following rules:
- try to drink enough water daily;
- give preference to steamed dishes;
- eat plenty of fiber-rich foods (cereals, vegetables, fruits) every day.
Let us dwell separately on freshly squeezed carrot juice. It is ideal for complex therapy, maintaining immunity and vision, and also has an excellent effect on the functioning of the genitourinary system, helping to fight urinary incontinence. To get rid of the problem, drink a glass of this juice every morning before breakfast, which is inexpensive and can be made by yourself at home.
What to do if all else fails
If you have been using traditional methods of treating urinary incontinence in women for a long time, and there is no desired result, or the disease returns quickly, you need to consult a doctor (a visit to the latter is mandatory if you experience pain, fever, or a change in urine color). After collecting an anamnesis, the specialist will conduct a diagnosis, including the following steps:
- general urine analysis;
- examination of the vagina with a smear collection for laboratory research;
- ultrasound examination of the kidneys, bladder, and ureter for inflammation.
Additionally, an assessment of the volume of residual urine, examination of the pelvic organs can be prescribed.
Treatment prognosis for urinary incontinence
In practice, the problem is treated quite successfully, provided that the cause of the disease is detected in a timely manner and its relief. If there are no strong inflammatory processes or objective factors for which a person cannot control urination, then the problem disappears quickly enough. An exception would be, for example, pregnancy, when the pressure on the bladder from the fetus disappears automatically after childbirth and recovery.
