2024-05-03 15:58:11
Urinary incontinence… solutions and strategies to regain bladder control
Urinary incontinence is the accidental, unintentional loss of urine. Urinary incontinence may be a temporary condition as a result of an underlying medical condition. It can range from discomfort due to loss of urine to intense and frequent urination.
According to the National Continence Association, more than 25 million American adults suffer from temporary or chronic urinary incontinence.
Research has found that at least half of people with urinary incontinence do not discuss their condition with their healthcare providers, when they don’t need to feel embarrassed. If you have a leaky bladder, rest assured that you are not alone with this health problem.
Leaky bladder, or urinary incontinence, affects women and men of all ages, and is more common later in life.
Causes and types
Dr. Edward says. Edward James Wright, MD, MD, director of urology at Johns Hopkins Bayview Medical Center – Urinary incontinence (UI) is certainly a very important disease and deserves discussion 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 causes urinary incontinence? Urinary incontinence is not an inevitable consequence of aging, but it is particularly common in older people. It is often caused by specific changes in bodily functions that may result from disease, medication use and/or the onset of the disease.
• Sometimes this is the first and only sign of a urinary tract infection. Women are more likely to develop urinary incontinence during pregnancy and after childbirth, or after hormonal changes associated with menopause.
• What types are there? What are the differences between them?
Urge Incontinence: The inability to hold urine long enough to go to the bathroom. It may be related to the need to urinate frequently and feeling a sudden strong urge to urinate. It can be an isolated condition, but it can also be an indicator of other diseases or conditions that 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: Leakage of urine due to difficulty going to the bathroom on time due to physical conditions, such as arthritis, injury or other disabilities.
Overflow Incontinence: Leakage occurs when the amount of urine produced exceeds the bladder’s ability to hold it.
Symptoms and diagnosis
• Common symptoms include:
Need to rush to the bathroom and/or lose urine if it doesn’t come in time.
Leakage of urine with movements or exercise.
Leakage of urine by coughing, sneezing, or laughing.
Always feeling wet without feeling urine leaking.
A feeling of not emptying the bladder completely.
Leakage of urine that started or continues after surgery.
• How is urinary incontinence diagnosed? For people with urinary incontinence, it is important for them to consult a health care provider. In many cases, patients are referred to a doctor who specializes in urology. Urinary incontinence is diagnosed through a complete physical examination that focuses on the urinary and nervous systems, reproductive organs, and urine samples. According to the Johns Hopkins team.
Steps to avoid urinary incontinence
Regarding strategies to regain control of bladder leakage, Dr. Edward James Wright from the Johns Hopkins Bladder Leakage Center offers good news and new hope, saying: “The vast majority of cases can be treated or significantly improved, regardless of the cause of bladder leakage. .” Wright continues: “There are many solutions available, but the patient can only get help to talk and explain what he wants.”
Here are some strategies that will 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 – soft drinks – chocolate – citrus fruits and tomatoes – corn syrup – honey.
– Second: Get rid of excess weight. The research found that obese women who lost weight reported fewer episodes of bladder leakage.
– Third: Bladder training Some exercises can help to keep the bladder under better control, for example practicing Kegel exercises, in which certain muscles in the pelvis are regularly tightened to strengthen them, which helps them to be more leak resistant. And “Mawhiba” exercises, where “Kegel exercises” are used while you cough, sneeze, or do any other activity that causes leakage. The latter requires a specialist, doctor or physical therapist, to explain how to do it correctly.
– Fourth: To identify the treatment options, in which the choice is made depending on the type of urinary incontinence, according to Dr. I saw, and it is as follows:
. Medications, which can help the bladder hold more volume, reduce bladder urgency, and improve the ability to empty the bladder. An over-the-counter patch has recently been approved for women with an overactive bladder that helps relax the bladder muscle; It is available to men on prescription.
. Botox injections into the lining of the bladder to prevent the release of a chemical that triggers muscle contractions.
. An injection of a thick material around the urethra (the tube that carries urine out of the body) to help hold the urine.
. Surgery to insert mesh tape to compress the urethra and prevent leakage.
Treatment of urinary incontinence
To manage urinary incontinence, many women wear protective diapers to protect their clothes from urine 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 treating physician will usually determine the appropriate treatment for urinary incontinence based on the following indicators:
Age, general health, and medical history.
Type of urinary incontinence and degree of impact.
The patient’s tolerance of medications or therapeutic procedures.
Prognosis for the course of the disease.
Patient opinion and preferences regarding treatment methods.
Treatment may include:
First: Behavioral treatments, including:
Bladder training: Teaching a person how to resist the urge to void and gradually lengthen the intervals between voids.
Assistance with toilets: Usually, scheduled, and urging urination to empty the bladder regularly to prevent leakage.
Dietary modifications: Eliminate bladder irritants, such as caffeine, alcohol, and citrus fruits.
Second: Rehabilitate the pelvic muscles (to improve the strength of the pelvic muscles and prevent leaking) by practicing specific exercises, including:
Kegel exercises: to improve urinary incontinence, and even prevent it.
Biofeedback: Used with Kegel exercises to gain awareness and control of the pelvic muscles, according to Mayo Clinic staff.
Vaginal weight training: Small weights are held inside the vagina by tightening the vaginal muscles.
Pelvic floor electrical stimulation: Mild electrical pulses stimulate muscle contraction.
Third: Drug treatment
Anticholinergic medications.
vaginal estrogen.
Pessary (a small rubber device worn inside the vagina to prevent leakage).
Botox is injected into the bladder.
Urethral bulking agents.
Peripheral nerve stimulation.
Fourth: Surgical treatment
Slings: They can be made of synthetic mesh or special tissue.
Bladder suspension procedure.
Peripheral nerve stimulation process.
Surgery for stress urinary incontinence in women may provide 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 more risk 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 of each procedure, as well as your specific health and treatment needs.
Potential complications and risks
Like any surgical procedure, urinary incontinence surgery has risks, although rare, including:
Temporary difficulty urinating.
Temporary difficulty emptying the bladder (urinary retention).
Development of an overactive bladder.
Urinary tract infection.
Wound infection.
Difficult or painful sex.
Extrude surgical material into the vagina.
Pain in the thigh.
Finally, we recommend talking to your surgeon about the potential risks and benefits of the surgical option.
Preoperative recommendations
Before deciding on surgery and its type, the patient should consider the following recommendations:
Get an accurate diagnosis. A genitourinary doctor (or urologist) performs additional diagnostic tests.
Understand that surgery only corrects the problem it is designed to treat. For example, surgery for stress urinary incontinence with a sudden, intense urge to urinate (overactive bladder) does not treat it, and mixed incontinence – a combination of stress urinary incontinence and an overactive bladder – will likely require additional treatments.
Thinking about future plans for having children. The doctor may recommend waiting to have surgery until you have children. The stress of pregnancy and childbirth on the bladder, urethra and supporting tissues can negate the benefits of surgical treatment.
Finally, we recommend to everyone who suffers from urinary incontinence: “Don’t let urinary incontinence prevent you from enjoying life Review, discuss and follow up with the urologist, because he will definitely give you appropriate solutions to live well with your condition.”
• Community medical adviser
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