Contents
An unpleasant smell, a feeling of discomfort, a lack of control over your own body and a great fear of contact with other people. These are problems that an increasing number of women struggle with.
Who gets urinary incontinence
Urinary incontinence, i.e. any uncontrolled leakage of urine from the bladder, is a disease the causes of which can be extremely diverse. It most often affects women in the fifth decade of life (i.e. premenopausal or early menopause), the prevalence decreases between the age of 55 and 64 and increases again after the age of 80. It is estimated that 1 in 4 women face this problem, although doctors have warned that this is only the tip of the iceberg. The most common form of urinary incontinence is stress (it affects almost all people suffering from this disease), then mixed (about 30%) and urgent (14%). Urinary incontinence can be related to physical activity such as exertion, long standing, lifting heavy objects, and even laughing and sneezing. Another form is urge incontinence and mixed urinary incontinence, and overflow incontinence associated with comorbidities such as multiple sclerosis, the presence of fistulas, urethral diverticula and congenital developmental disorders. However, the most common cause is aging of the anatomical structures of the urinary system.
What is incontinence
In a properly functioning human body, urine produced by the kidneys flows into the bladder and the urethra is clamped by the surrounding pelvic floor muscles. A full bladder sends a signal to the brain to urinate. When we want to urinate, the brain sends a signal to the pelvic muscles to relax and the bladder to contract. The result is micturition, i.e. urination. However, if any irregularities appear at any of the stages, the mechanism may be disturbed.
Often, however, urinary incontinence is a temporary condition resulting from urinary tract infection, atrophic vaginitis. It can also be influenced by mental factors such as stress or depression. Excessive diuresis can also be the result of certain cardiac or muscle relaxant medications, and the consumption of citrus, alcoholic and caffeinated drinks.
Diagnostics and treatment of urinary incontinence
It can happen to any healthy person, but chronic urinary incontinence is always a signal of organism dysfunction and requires medical consultation. Your primary care physician may refer you to a specialist, urologist, gynecologist, or neurologist. Properly conducted diagnostics allows for the selection of the optimal treatment for a given type of clinical treatment. The basis for the diagnosis, apart from the physical examination, are the results of urine and blood tests. In some situations, it may be necessary to perform urodynamic diagnostics, which allows to visualize the symptoms of the lower urinary tract. It may be supplemented with an ultrasound examination of the smaller pelvis.
The first stage of therapy is usually Kegel exercises and electrostimulation, which, however, is not always available at the clinic. If this proves unsuccessful, the doctor may decide to initiate drug therapy. It will be the first-line treatment for people with overactive bladder who experience symptoms such as pollakiuria, urgency and nocturnal urination (called nocturia). On the other hand, in the case of stress urinary incontinence or when an additional complication is pelvic statics disorders, e.g. lowering of the vaginal walls, surgical treatment is considered. Surgical treatment consists of the application of a suburethral sling or mesh implants. This usually allows for a complete recovery, although in some (rare) cases, re-operations may be necessary.
Incontinence prophylaxis
1. Change your diet. The key is to limit the intake of fluids, especially coffee, strong tea and alcohol.
2. If you are overweight, try to lose weight.
3. Avoid having to lift heavy objects.
4. Strengthen Kegel muscles – use vaginal balls and cones of variable size and weight.
5. Follow behavioral therapy (bladder training) as directed by your doctor.
6. Play sports (except for those disciplines where it is necessary to lift weights or put pressure on the perineum).
7. Use urological inserts that ensure long-lasting freshness and effective protection.
8. To prevent urine leakage during sexual intercourse, be sure to go to the toilet beforehand. It is beneficial to change sexual positions carefully and slowly.