Urinary incontinence is a very common and extremely delicate problem faced by millions of people regardless of gender and age. Unfortunately, very often patients do not seek help from a doctor, trying to cope with the disease on their own.
Incontinence is not natural to the body. This is a disease that needs treatment. That is why it is worth learning more about the causes and effective therapeutic methods to help cope with the disease.
What is a disease?
Many people today are looking for information about the causes and treatment of urinary incontinence. But first, you should familiarize yourself with some anatomical and functional features of the urinary system.
As you know, urine is produced by the kidneys, from which it enters the bladder through the ureter. As fluid accumulates, pressure on the walls of the bladder increases, which activates nerve receptors - a person has a desire to empty himself. Normally, people can control the process, restrain urination for a sufficiently long time.thanks to the work of the sphincters. But sometimes the process is disrupted - urine can flow out on its own, without the urge, or the urge can be so intense that the patient simply cannot restrain himself.
Many people suffer from this problem. According to statistics, approximately 40% of women experience this problem after menopause. In men, a similar ailment is diagnosed 4–5 times less often, but the likelihood of its development should not be ruled out either. Many patients consider involuntary leakage of urine a natural process associated with the gradual aging of the body. This is an erroneous opinion - incontinence is a pathology that needs to be treated.
Urinary incontinence: causes and risk factors
Lack of control over urination can develop under the influence of many factors. The list of possible causes is quite impressive:
- According to statistics, women suffer from this pathology many times more often. This is due to some anatomical differences in the female genitourinary system.
- Risk factors include advanced age. For example, urinary incontinence in women after 50 years of age (as well as in men) is diagnosed much more often than in younger patients. This is due to the developing weakness of the muscles and ligaments in the pelvis, as well as changes in the hormonal background. For example, in the fair sex, after the onset of menopause, the level of estrogen is significantly reduced, which affects the structure of muscle and connective tissues.
- Incontinenceurine in men often develops against the background of problems with the prostate gland (for example, chronic prostatitis, adenoma, the formation of malignant tumors).
- Obesity is also considered a risk factor. Excess weight creates additional pressure on the pelvis, which leads to displacement of organs, stretching of muscles and ligaments.
- It is believed that the likelihood of such a problem increases with smoking.
- Meaning has food and drinking regimen. For example, foods and drinks such as chocolate, tomatoes, coffee, and alcohol irritate the bladder mucosa, which, in the presence of some other factors, can lead to the development of incontinence.
- Urine incontinence often develops in women after pregnancy and childbirth. The fact is that the growth of the fetus leads to a displacement of the pelvic organs, sprains, weakening of the muscles. In addition, during childbirth, tissues are often injured, which also results in problems with urination.
- Various neurological disorders can also provoke incontinence, for example, against the background of multiple sclerosis or as a result of a stroke.
- There are a number of other diseases that in certain situations can lead to urination disorders. Their list includes diabetes mellitus, kidney disease, chronic constipation, urinary tract infections, peripheral nerve and spinal cord lesions.
- Urinary incontinence can be a side effect of taking certain medications, such as blockers, hormones, diuretics, etc.
- There is a certaingenetic predisposition.
- The disease sometimes develops after undergoing surgical procedures on the pelvic organs.
- Problems appear due to some diseases of the genitourinary system, if against their background the formation of scar tissue is observed.
- Urinary incontinence in women aged 50 and older may be due to partial or complete prolapse of the internal organs of the reproductive system.
- Illness may be related to radiation exposure.
Stress incontinence: clinical features
Stress incontinence is said to be when urination occurs involuntarily during tension in the abdominal wall and increased intra-abdominal pressure. For example, such episodes occur during coughing, loud laughter, sneezing, lifting weights. At the same time, there is no urge to empty the bladder - just a small amount of urine is released.
Stress incontinence is most often associated with a weakening of the pelvic floor muscles and a decrease in the level of collagen in the ligaments. In most cases, women face a similar problem.
Urgent form of the disease
The urgent (imperative) form of the disease is also considered common. In this case, the urge to emptying occurs, but is imperative. The patient experiences an irresistible need to urinate, and immediately. It is almost impossible to restrain or even slightly delay urination.
Imperative urge may occur after leaving a warm room in the cold. The sound of flowing water or the influence of other environmental factors can provoke urination. In any case, the patient cannot control the process of urination, which leads to a lot of social complications (a person is literally afraid to go outside, receive guests, communicate with people).
Functional incontinence
Sometimes an ailment is in no way connected with a violation of the structure of the genitourinary system - all organs retain their functional properties, but it is still not possible to control urination. The causes of urinary incontinence in this case may be as follows:
- progressive Parkinson's disease;
- Alzheimer's disease, dementia and other forms of dementia;
- severe depression and some other mental disorders.
Other types of incontinence
There are other forms of urinary incontinence, the development of which is also often recorded in modern medical practice.
This is:
- Nocturnal enuresis - involuntary urination during sleep. Children most often suffer from this pathology.
- Neurogenic bladder syndrome, in which the innervation of the urination organs is impaired (the patient simply does not feel the urge and, accordingly, is unable to control them).
- Iatrogenic incontinence develops with certain medications.
- Full incontinence (paradoxical) is associated with overflow and subsequent overdistension of the bladder. Thisthe form of the disease, as a rule, is associated with a violation of the normal outflow of urine against the background of prostate adenoma, cancer, urethral stricture, etc. In most cases, such urinary incontinence develops after 50 years.
- A mixed form of the disease is also possible, which combines the symptoms of imperative and stress incontinence.
In the process of diagnosis, it is very important to determine the form of the disease and the causes of its occurrence. Only in this way the doctor will be able to draw up a truly effective treatment regimen.
Possible Complications
This is a very common problem faced by millions of people, especially in adulthood, after 50 years. Urinary incontinence, if left untreated, can lead to unpleasant and sometimes dangerous complications:
- According to statistics, impaired urine outflow, fluid stagnation, changes in the structure of the urinary organs increase the risk of developing cystitis, urethritis, pyelonephritis and other diseases.
- Excreted urine, as a rule, comes into contact with the skin, irritates the delicate tissues in the perineum and inner thighs. Gradually, the skin turns red, diaper rash appears on it. Pathological processes often lead to the development of dermatitis, and the risk of tissue infection by pathogenic bacteria and fungi increases.
- Of course, urinary incontinence simply cannot but affect the emotional state of the patient. The inability to control one's own bladder forces a person to change their lifestyle. People suffering from this problem become withdrawn, experienceproblems with communication, sexual life, etc. There is a decrease in working capacity, the development of various neuroses and depressive states.
Naturally, timely treatment (including surgery) and the right lifestyle can minimize the likelihood of complications. That is why in no case should you refuse medical help.
Diagnostic procedures
You should definitely inform your doctor about the appearance of such a problem. Proper diagnosis is extremely important. The specialist should determine the cause of the disease (for example, urinary incontinence in the elderly may be caused by other causes than the same problem in younger patients).
- First, a general examination and data collection for anamnesis is carried out. The doctor will ask questions about previous illnesses, lifestyle, daily habits. Surely the specialist will ask you to keep a diary of urination.
- Also, the patient takes blood and urine tests - this makes it possible to detect an existing inflammatory process.
- Using a soft tube and a special catheter, the volume of residual urine is measured (normally, this figure should not exceed 50 ml). The same procedure can be performed using an ultrasound scanner.
- Cystometry is also informative. During the procedure, the doctor can determine the maximum volume of the bladder, as well as the pressure that the walls of the organ can withstand.
- Uroflowmetry - a procedure that allows you to measure the flow rateurine.
- Cystoscopy is also obligatory. This is an endoscopic procedure, during which the doctor carefully examines the inside of the bladder using special equipment in order to detect any abnormalities (for example, the appearance of neoplasms, scar tissue, etc.).
- Electromyography is performed if there is a suspicion of conduction disturbances in nerve fibers. During the procedure, special sensors are used that measure the electrical activity of the muscles and nerves around the bladder sphincter.
Medicated treatment
Immediately it should be said that the treatment of urinary incontinence must be comprehensive. Therapy includes both medications and other techniques.
According to statistics, drugs used in modern medicine are most effective in imperative forms of the disease. Treatment in this case is aimed at relieving muscle spasms, normalizing nerve conduction:
- Anticholinergic drugs help relieve spasm from the muscular walls of the bladder, thereby increasing its volume. Medications help with the increased urge to urinate before the bladder is full.
- Urinary incontinence in men is sometimes treated with alpha-blockers. Such drugs provide relaxation of smooth muscles, and also help to cope with prostate adenoma (an enlarged prostate is often the cause of incontinence).
- Deal with urgessometimes antidepressants help too.
- If urinary problems are associated with menopause, then women may be prescribed hormonal drugs.
Non-drug therapies
Medical treatment of urinary incontinence can reduce some of the symptoms, but, unfortunately, it cannot completely eliminate the problem. That is why some other procedures are included in the therapy regimen:
- Kegel exercises are mandatory. Such physical education helps to strengthen the muscles of the pelvic floor, improve blood circulation, and eliminate stagnant processes. The exercises are simple, therefore accessible to people regardless of gender and age. They need to be repeated daily.
- Effective is the training of urination. Its essence is simple: feeling the urge to empty, you need to try to restrain them for at least a few minutes. In the future, the interval between urination should be gradually increased. Ideally, the patient manages to create a schedule of emptying and strictly follow it.
- Coffee, cocoa, alcohol, spices and spices should be excluded from the diet, as these products irritate the bladder wall and provoke its uncontrolled emptying.
Urinary incontinence: surgery
When it comes to mild incontinence, exercise and a little lifestyle adjustment will be enough to fix the problem. But sometimes the only way out is surgery.interference.
- In most cases, special slings are installed, which normalize the processes of urination, relieve pressure from the walls of the bladder.
- In more severe cases, Birch's operation is performed. This is a complete abdominal procedure that involves surgically attaching the top of the vagina to the abdominal wall.
- If there is a malfunction of the sphincter, then the patient can install an internal implant (a kind of cuff on the urinary canal), which is controlled using a special pump. In most cases, artificial sphincters are placed in men who have undergone surgical removal of the prostate.
- Sometimes the doctor introduces special dry mixtures containing collagen into the area of the sphincter and urinary canal. The mixture helps to give volume to the surrounding tissues, make the sphincter more elastic and elastic.
- Sacral stimulation (sacral nerve stimulation) is sometimes recommended if neurological disorders are present. A special device is installed in the sacrum area, which normalizes the transmission of nerve impulses to the bladder and in the opposite direction.
Treatment with folk remedies
It should be said right away that home remedies can only be part of an adjunctive therapy - they are not able to completely eliminate incontinence or eliminate the cause of its occurrence.
- Some folk healers recommend drinking dill decoction daily. To prepare it, you needpour a tablespoon of dill seeds into a thermos, pour everything with a glass of boiling water, close the lid and leave for two hours. Then the resulting mixture is filtered and drunk.
- Effective is a decoction of the leaves of St. John's wort and lingonberries. A mixture of dried herbs is used to prepare a tea that is consumed daily (may be slightly sweetened).
- You can make an infusion of corn stigmas. A teaspoon of raw materials is poured with a glass of boiling water, covered with a lid and infused for 15 minutes. The mixture is then strained and drunk.
Of course, self-medication in this case is not worth it. If you still decide to take home-made medicines, then you must first consult your doctor.
