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Another ailment that is not talked about loudly. In our place. In the USA, Whoopi Goldberg broke the silence with a spectacular advertising campaign. In a series of videos, she played famous women who had a common problem with urinary incontinence. Cleopatra could not take part in the dance feasts because exercise caused urine to flow out. Joan of Arc had successfully used the imperfections of her bladder to extinguish the pile on which she had unsuccessfully attempted to burn her. Whoopi Goldberg herself adds: – Yes, I have it and every third woman also has it. Saying it out loud is the first step to starting effective therapy.
Urinary incontinence, which is an unlucky coil
Urinary incontinence is the lack of control over the flow of fluid from the bladder. Twice more often it happens to women than men (it is related to the anatomical structure, women have a much shorter urethra) and, contrary to common beliefs, it does not only apply to older women. The fact that the likelihood of NTM increases with age, however, it happens that already twenty-year-old girls suffer from the disease.
The main types of the disease are stress urinary incontinence and urge incontinence.
The first was about Cleopatra and Joanna D’Arc by Whoopi Goldberg: when the pressure in the abdominal cavity rises, the urine is pressed out. It happens when you sneeze, cough, laugh, give yourself a strong hug or exercise. Due to the severity of symptoms, three levels of stress NTM are distinguished, from leakage in the standing position, with high abdominal muscle tension, to incidents in the supine position with minimal effort. The root cause is mechanical: the bladder loses the support that should be provided by the pelvic muscles. When they go limp and fall, the position of internal organs changes, and thus the pressure system. The pressure in the bladder is so high that the urethra is not enough to close the outflow. The main triggers are hormonal changes during menopause, as well as pregnancy and childbirth.
Dr. Wojciech Malottki from the Center of Minimally Invasive and Laser Urology “U-Med” in Kalisz adds to the elements increasing the probability of NTM:
– Obesity is also a risk factor, i.e. a condition when muscle tissue is replaced by adipose tissue and low physical activity.
Urinary incontinence – symptom or disease
The feeling of pressure on the bladder is known to everyone who has ever given up the chance to pee before a trip and then got stuck in a traffic jam. Pathological pressure on the bladder differs from the physiological one in that it occurs suddenly and cannot be waited out: if we do not get to the toilet immediately, urine will leak out by itself. The pressure may appear for no reason, or it is caused by stress, temperature changes, or even the sound of flowing water. If it is not a symptom of a disease, it is usually difficult to find out the causes of urge incontinence.
Exactly, but what is it like, urinary incontinence is a disease or a symptom of a disease?
– It depends on the components of a given case, which is why careful and accurate diagnosis is so important. For diagnostic purposes, a urodynamic test is performed – says Wojciech Malottki, MD, PhD. – Urinary incontinence is sometimes caused by mechanical factors, changes in the structure of the pelvis or disturbances in the statics of the reproductive organs, but it can also be a symptom of serious neurological diseases or degeneration of the spine.
However, even if our case of NTM is “just” an ordinary plumber, the condition makes life very difficult and qualifies, according to Dr. Malottki, as a social disability. The stress experienced by women who do not control their bladder sometimes even excludes them from social and social life. They must have a toilet within three steps. They are finished with wet underwear, irritation of the skin constantly in contact with urine and the accompanying unpleasant smell of decomposing urine. Some people also give up their intimate life, because urine can leak out also during sex. And if only they were not ashamed to see a doctor …
Treatment and prevention of urinary incontinence
The problem of urinary incontinence is considered embarrassing, therefore, along with dozens of other supposedly embarrassing conditions – and let’s think about what can be embarrassing about any disease for a doctor specializing in it ?! – he is sometimes left unsaid, and the patients take their own chance for effective treatment. Because NTM can be treated, and the effectiveness of a well-chosen therapy reaches up to 90%!
After careful diagnosis, showing the actual causes, the doctor (family doctor, gynecologist or urologist) has a choice of conservative, pharmacological and operational methods. Conservative methods include electrostimulation and exercises to strengthen the muscles of the diaphragm, pelvis and perineum, incl. famous Kegel exercises, which are not only an element of treatment, but also an excellent prophylaxis (and additionally lead to the intensification of sexual sensations! They consist in tightening the vaginal and anus muscles so as to stop the urine stream. dry “).
Among pharmacological agents, estrogen hormone therapy is used, especially in postmenopausal patients. If these methods fail, a surgical operation can be performed. These are not complicated but effective treatments.
In the case of urge urinary incontinence, no surgical treatment is used, focusing on conservative and pharmacological therapy.
So, since the methods of treatment are known and effective, it is not worth experiencing the enormous stress associated with the symptoms of urinary incontinence. However, if it takes some time to decide on treatment, remember that instead of ordinary sanitary napkins, it is worth using the so-called urological insoles, reimbursed by the National Health Fund and available in pharmacies (also online!), which are, firstly, much more absorbent and, secondly, neutralize the unpleasant smell of urine.
After all, in our time no one is being burned at the stake anymore, so it makes no sense to cuddle NTM for the situation in which it saved the life of Whoopi Goldberg played by Joanna D’Arc. About 4 million Polish women suffer from urinary incontinence. There may be much less of them.