2024-05-03 15:58:11
Urinary incontinence… solutions and strategies to regain bladder control
Urinary incontinence is an accidental and involuntary loss of urine. Urinary incontinence may be a temporary condition resulting from an underlying medical condition. This can range from discomfort caused by loss of urine to severe and frequent urination.
According to the National Association for Continence, more than 25 million American adults suffer from temporary or chronic urinary incontinence. Urinary incontinence can occur at any age, but is more common in women over 50.
Research has shown that at least half of people with urinary incontinence do not discuss their condition with their health care providers, even though there is no reason to feel embarrassed. If you suffer from urinary leakage, rest assured that you are not alone in facing this health problem.
Bladder leaks, or urinary incontinence, affect women and men of all ages and are more common later in life.
Causes and types
said Dr. Edward. Edward James Wright, MD, MD, Director of Urology at Johns Hopkins Bayview Medical Center – Urinary incontinence (UI) is certainly a very important condition and worth discussing. in the complex interactions between the brain, nervous system and pelvic organs. There are many causes of urinary incontinence, many of which can be treated with surgical and non-surgical treatments.
• What are the causes of urinary incontinence? Urinary incontinence is not an inevitable consequence of aging, but it is particularly common among older people. It is often caused by specific changes in bodily functions that may result from illnesses, the use of medications, and/or the onset of illness.
• Sometimes it is the first and only symptom of a urinary tract infection. Women are more likely to develop urinary incontinence during pregnancy and following childbirth, or following hormonal changes associated with menopause.
• What are its types? What are the differences between them?
Urge incontinence: inability to hold urine long enough to go to the toilet. This may be associated with the need to urinate frequently and a sudden strong urge to urinate. It may be an isolated condition, but it may also be an indicator of other illnesses or conditions that also require medical attention.
Stress incontinence: leaking urine during exercise, coughing, sneezing, laughing, lifting heavy objects, or performing other body movements that put pressure on the bladder.
Functional incontinence: leaking urine due to difficulty getting to the toilet on time due to physical conditions, such as arthritis, injury, or other disabilities.
Overflow incontinence: A leak occurs when the amount of urine produced exceeds the bladder’s ability to hold it.
Symptoms and diagnosis
• Common symptoms include:
The need to rush to the toilet and/or loss of urine if it does not arrive in time.
Leaking urine with movement or exercise.
Leaking urine accompanied by coughing, sneezing or laughing.
Always feeling wet without feeling urine flowing.
Feeling as if the bladder is not completely empty.
Urinary leakage that started or continues following surgery.
• How is urinary incontinence diagnosed? For people suffering from urinary incontinence, it is important that they consult a healthcare professional. In many cases, patients are then referred to a doctor who specializes in urology. Urinary incontinence is diagnosed by a complete physical examination focusing on the urinary and nervous systems, reproductive organs, and urine samples. According to the Johns Hopkins team.
Steps to Avoid Urinary Incontinence
Regarding strategies for regaining control of bladder leakage, Dr. Edward James Wright of the Johns Hopkins Bladder Leakage Center offers good news and new hope, saying: “The vast majority of cases can be treated or significantly improved, whatever the cause of urinary leakage. .” Wright continues: “There are many solutions available, but the patient can only get help for what they want to talk regarding and explain. »
Here are some strategies that can help you:
– First: review your diet. You may be able to reduce bladder leakage by avoiding certain foods, drinks and ingredients, including: alcohol – artificial sweeteners – caffeine – carbonated drinks – chocolate – citrus fruits and tomatoes – corn syrup – Honey.
– Second: get rid of excess weight. Research has shown that obese women who lost weight reported fewer episodes of bladder leakage.
– Third: Bladder training. Certain exercises can help improve bladder control, such as doing Kegel exercises, in which certain muscles in the pelvis are contracted regularly to strengthen them, helping them become more resistant to leaking. And “Mawhiba” exercises, in which “Kegel exercises” are used while coughing, sneezing, or doing any other activity that results in leaking. The latter requires a specialist, doctor or physiotherapist, to explain to you how to do it correctly.
– Fourth: Identify treatment options, in which the choice is made depending on the type of urinary incontinence, according to the opinion of the Dr. I saw, and it is the following:
. Medicines that can help the bladder retain more volume, reduce bladder urgency, and improve the ability to empty the bladder. There is a recently approved over-the-counter patch for women with overactive bladder that helps them relax their bladder muscles; It is available to men by prescription.
. Botox injections into the lining of the bladder to prevent the release of a chemical that stimulates muscle contractions.
. Injection of thick material around the urethra (the tube that carries urine out of the body) to help retain urine.
. Surgery to insert a mesh tape to compress the urethra and prevent leaking.
Treatment of urinary incontinence
To manage urinary incontinence, many women wear protective diapers to protect their clothing from urinary leakage. Alternatively, specially designed absorbent underwear, similar in appearance to regular underwear, can be easily worn under everyday clothing.
According to the Mayo Clinic team, the appropriate treatment for urinary incontinence is usually determined by the treating physician based on the following indicators:
Age, general health and medical history.
Type of urinary incontinence and extent of its impact.
The patient’s tolerance to medications or therapeutic procedures.
Prognosis of the progression of the disease.
Patient opinion and preferences regarding treatment methods.
Treatment may include the following:
First: behavioral treatments, including:
Bladder training: teaching a person to resist the urge to urinate and gradually extend the intervals between urination.
Toileting aid: routine, scheduled and urgent urination to empty the bladder regularly to prevent leaks.
Diet changes: Eliminate bladder irritants, such as caffeine, alcohol, and citrus fruits.
Second: Pelvic muscle rehabilitation (to improve pelvic muscle strength and prevent leaks) by practicing specific exercises, including:
Kegel exercises: to improve urinary incontinence, or even prevent it.
Biofeedback: It is used with Kegel exercises to gain awareness and control of the pelvic muscles, according to the Mayo Clinic team.
Vaginal strength training: small weights are held inside the vagina by tightening the vaginal muscles.
Electrical stimulation of the pelvic floor: slight electrical impulses stimulate muscle contractions.
Third: drug treatment
Anticholinergic drugs.
Vaginal estrogen.
Pessary (a small rubber device worn inside the vagina to prevent leaking).
Botox injection into the bladder.
Urethral bulking agents.
Peripheral nerve stimulation.
Fourth: surgical treatment
Slings: They can be made of synthetic mesh or special fabrics.
Bladder suspension procedure.
Peripheral nerve stimulation process.
Surgery for stress urinary incontinence in women can be a long-term solution, especially when other treatments have not worked.
Surgical treatment aims to support the urethra and bladder neck. This extra support helps keep the urethra closed when you apply pressure, so urine doesn’t leak out.
Although surgery carries a higher risk of complications than other treatments, it can provide a long-term solution. Finding the best option for stress urinary incontinence surgery depends on the benefits and risks associated with each procedure, as well as your specific health and treatment needs.
Potential complications and risks
Like any surgical procedure, urinary incontinence surgery carries risks, although rare, including:
Temporary difficulty urinating.
Temporary difficulty emptying the bladder (urinary retention).
Development of an overactive bladder.
Urinary infection.
Wound infection.
Difficult or painful sexual intercourse.
Extrusion of surgical material into the vagina.
Pain in the thigh.
Finally, we recommend discussing with your surgeon the potential risks and benefits of the surgical option.
Preoperative Suggestions
Before deciding on surgical intervention and determining its type, the patient should consider the following suggestions:
Get an accurate diagnosis. Different types of urinary incontinence require different treatments. A genitourinary doctor (or urologist) performs other diagnostic tests.
Understand that surgery only corrects the problem it is designed to address. For example, surgery for stress urinary incontinence does not treat sudden, intense urges to urinate (overactive bladder), and mixed incontinence – a combination of stress urinary incontinence and overactive bladder – will likely require additional treatment.
Think regarding future plans for having children. The doctor may recommend that you wait to have surgery until you are finished having children. The stress of pregnancy and childbirth on the bladder, urethra and supporting tissues can negate the benefits of surgical treatment.
Finally, we advise all people suffering from urinary incontinence: “Don’t let urinary incontinence stop you from enjoying life. Review, discuss and follow up with the urologist, he will certainly be able to give you the appropriate solutions to cope well with your condition.
• Community medicine consultant
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