For a healthy organism, control over the excretion of urine is the norm. But if this control weakens, it's time to think about your health. The process of involuntary urination can not be called a norm. This condition is called incontinence.
Forms of urinary incontinence:
- Stress form. When urine is uncontrollably released at emotional stress;
- The imperative form is characterized by the impossibility of restraining urge to urinate;
- Mixed form.
Each form of urinary incontinence has its own characteristics, to which also the approach should be individual.
- 1 Involuntary urination with stress
- 2 Causes of urinary incontinence with stress
- 3 Diagnosis of urinary incontinence
- 4 How is incontinence treated?
- 5 Conservative method of treatment
- 6 Surgical method of treatment
- 7 Complications after operations
Involuntary urination with
voltage The main symptoms of urinary tension in stress are: urine output during laughter, sneezing, coughing, physical activity and during intercourse. This is the so-called stress urinary incontinence. And stress, in this case, means some kind of effort or stress. In women with a diagnosis of "stress urinary incontinence" in a calm state, urine is not excreted.
At the first stages of the development of the disease, urine output does not occur every time a woman sneezes or laughs. It starts with a few lost drops with a full bladder. And further, without treatment, the disease can lead to the fact that the loss of urine will occur even in the process of ordinary walking.
Causes of urinary incontinence with voltage
Today there is no exact and complete answer to this question. But, according to doctors, stress urinary incontinence occurs due to the weakening of the ligament apparatus of the urethra. It happens that this pathology arises because of difficult and pathologically long delivery, because of a large fetus or a narrow pelvis. Each such case can lead to the development of stress urinary incontinence, associated with the stretching of ligaments and tissues around the vagina and urethra. Later, the restoration does occur, but it may be incomplete.
Also, the age index is important. In this case, the leading role will belong to a decreased sex hormone. This is especially true for women in the post-menstrual period. Lack of sex hormones badly affects the quality characteristics of tissues. And it can be seen on the skin, which becomes dry and flabby. This also happens with the bundles. Unfortunately, hormone replacement therapy has not yet taken root in our country, which can reduce the incidence of stress incontinence. But this disease can not be ignored, even if it is caused by natural causes.
In addition to these reasons, there are many other potentially leading to the development of involuntary urination .These include: chronic constipation, chronic obstructive pulmonary disease, bronchial asthma, that is, a disease characterized by a constant increase in intra-abdominal pressure. As well as childbirth, they cause overgrowth of the tissues and ligaments of the urethra.
You can also note the role of operations on a small pelvis. These operations include removal of the uterus and tightening the walls of the vagina.
Diagnosis of urinary incontinence
The diagnosis of urinary incontinence must begin with the maintenance of a diary of urination. In it, a woman should note how much liquid she drank in a day, how many times the bladder emptied, what was the volume of the allocated urine and how many episodes of involuntary urination and in what situations she counted. It is very important to talk with the patient and find out the nature of the disease, how it manifested itself, when and how it began, and also its impact on the quality of life. Each woman must undergo an examination on the gynecological chair, during which the doctor assesses the condition of her tissues and ligament apparatus, the presence of the uterus, vagina.
In addition, a cough test is conducted. This test is performed with a complete bladder. A woman is offered several times to coughed violently. If at that moment the urine is released, then it is possible to assume the presence of the disease "stress urinary incontinence".But medicine is built on an individual approach. And not always this test can draw a complete picture of the disease. In this case, a number of other, even more informative diagnostic activities will be carried out. These include: urodynamic studies, ultrasound of the pelvic organs, cystoscopy, etc. Cystoscopy is performed with a special device by the cystoscope, due to which the inner surface of the bladder is studied. A cystoscope is inserted through the urethra. An anesthetic gel is used, and the procedure takes no more than seven minutes.
Cystoscopy provides an opportunity to assess the condition of the bladder and to exclude the presence of tumors.
Urodynamic study is aimed at evaluating the process of filling and excretion of urine. It consists in the introduction of special information sensors into the vagina and bladder.
Ultrasound is used to detect pathologies of the reproductive system. Which may accompany the disease, or cause involuntary urination .
How is incontinence treated?
This question should be handled by experienced specialists. Since this disease is not life threatening, it is advisable to start treatment only if it causes considerable inconvenience to the patient.
Methods of treatment of urinary incontinence:
Conservative method of treatment
It consists in strengthening the muscles of the pelvic floor, which allows to establish the process of retention of urine. Such therapy is carried out in the form of exercises or wearing a weight in the vagina.
Previously existing Atabekov and Kegel exercises are rarely used today, but it has become a good basis for developing new therapeutic exercise complexes. Each program is developed individually by the physician of physiotherapy exercises.
Consider the use of such a therapeutic device as a vaginal cone. These are cone-shaped weights with a specially variable weight. One such cone is inserted into the vagina as a normal hygiene tampon. Having learned to hold the load inside the vagina, the woman thereby strengthens the muscles and ligaments, which allows her to hold the urine.
But conservative treatment may not be suitable for every woman. The main candidates for such treatment are young women after childbirth. They are best exposed to conservative treatment, because their body is still well regenerated, which can not be said about older women. Such treatment is carried out within three to six months.
If the patient refuses to undergo conservative treatment, the doctor has the right to offer her a surgical method of treatment.
Surgical method of treatment
Most often today, operations are performed using a loop that is placed under the middle part of the urethra .Synthetic material, from which the loop is made, is absolutely neutral, and does not cause any adverse reactions in the body. The operation is aimed at compensating for the imperfect ligamentous apparatus of the urethra and for strengthening the posterior wall of the urethra. Such operations are effective in 90% of cases, and help stop involuntary urination .
The introduction of such operations into everyday practice began in the mid-1990s, after which they were repeatedly modified. Today there are several types of loops, and which one should be put, the operating urologist himself decides. This, so-called, sling, or loop operations. As a rule, such operations are performed under spinal anesthesia. Sometimes spinal anesthesia is replaced by a local one. After it, the patient should not lift the weight and live a sexual life within a month. And to give birth after such operation the woman can only by cesarean section.
operations The main postoperative complication is difficulty urinating, as well as retention of residual urine as a result of incomplete emptying of the bladder. To eliminate such complications, appoint catheterization and physiotherapy aimed at activating the contractile function of the muscles of the bladder. In most cases, recovery takes a week. If this therapy does not work, then a second operation is performed and the loop is weakened. In case of relapse, repeat the sling operation.
Another frequent postoperative complication is hyperactive-bladder syndrome.
It happens and just an unsuccessful operation, after which the woman continues to lose urine, but already completely. And there may be some minor improvements. If the patient is dissatisfied, the surgeon can perform a second operation in a few months.
Dyspareunia is a condition in which a woman experiences pain and discomfort during sexual intercourse .It can also be a complication of sling surgery. But it is extremely rare.
With whatsoever is associated with involuntary urination , it is treated in a specially equipped hospital and under the strict supervision of specialists.