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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 resulting from an underlying medical condition. It can range from discomfort caused by loss of urine to severe and frequent urination.
According to the National Association for Continence, more than 25 million American adults suffer from temporary or chronic urinary incontinence. Urinary incontinence can occur at any age, but it is most common among women over the age of 50.
Research has found that at least half of people with urinary incontinence do not discuss their conditions with their healthcare providers, when there is no need to feel embarrassed. If you suffer from bladder leakage, rest assured that you are not alone with this health problem.
Bladder leakage, 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 worth discussing. It is a leak that does not Avulsion of the bladder can occur when something goes wrong 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 especially common in older people. It is often caused by specific changes in body functions that may result from diseases, use of medications and/or the onset of disease.
• Sometimes this is the first and only symptom 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 are its types? What are the differences between them?
Urgency Incontinence: The inability to hold urine long enough to get to the bathroom. It can be associated with needing to urinate frequently and feeling a strong, sudden urge to urinate. It can be an isolated condition, but it may also be an indicator of other diseases or conditions that also require medical attention.
Stress incontinence: Leakage of 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 getting to the bathroom in 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:
The need to rush to the bathroom and/or loss of urine if it does not arrive in time.
Urine leakage with movements or exercise.
Leakage of urine with coughing, sneezing, or laughing.
Always feeling wet without feeling urine leaking.
Feeling of not emptying the bladder completely.
Urine leakage 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 then 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 for regaining control of bladder leakage, Dr. Edward James Wright of 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 with what he wants to talk about and explain.”
Here are some strategies that can help:
– 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: Getting rid of excess weight. Research found that obese women who lost weight reported fewer episodes of bladder leakage.
– Third: Bladder training. Some exercises can help keep the bladder under better control, such as practicing Kegel exercises, in which certain muscles in the pelvis are tightened regularly to strengthen them, which helps them become more resistant to leakage. And “Mawhiba” exercises, in which “Kegel exercises” are used while coughing, sneezing, or performing any other activity that leads to leakage. The latter requires a specialist, doctor or physical therapist, to explain how to do it correctly.
– Fourth: Identifying the treatment options, in which the choice is made depending on the type of urinary incontinence, according to the opinion of Dr. Wright, 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. There is a recently approved over-the-counter patch for women with overactive bladder that helps them 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 stimulates muscle contractions.
. An injection of a thick material around the urethra (the tube that carries urine out of the body) to help hold in urine.
. Surgery to insert a mesh tape to compress the urethra and prevent leaks.
Urinary incontinence treatment
To manage urinary incontinence, many women wear protective diapers to protect their clothing from urine leakage. Alternatively, specially designed absorbent underwear, which is similar in appearance to regular underwear, can be easily worn under everyday clothing.
According to the Mayo Clinic team, the appropriate treatment for urinary incontinence is usually determined by the treating physician based on the following indicators:
Age, general health, and medical history.
Type of urinary incontinence and extent of its impact.
The patient’s tolerance for medications or therapeutic procedures.
Prognosis for the course of the disease.
Patient’s opinion and preferences for treatment methods.
Treatment may include the following:
First: Behavioral treatments, including:
Bladder training: Teaching a person how to resist the urge to void and gradually extend the intervals between voiding.
Assistance with toileting: Routinely, scheduled, and urging urination to empty the bladder regularly to prevent leakage.
Diet modifications: Eliminate bladder irritants, such as caffeine, alcohol, and citrus fruits.
Second: Rehabilitation of the pelvic muscles (to improve the strength of the pelvic muscles and prevent leakage) by practicing specific exercises, including:
Kegel exercises: to improve urinary incontinence, and even prevent it.
Biofeedback: It is used with Kegel exercises to gain awareness and control of the pelvic muscles, according to the Mayo Clinic team.
Vaginal weight training: Small weights are held inside the vagina by tightening the vaginal muscles.
Pelvic floor electrical stimulation: Mild electrical pulses stimulate muscle contractions.
Third: Drug treatment
Anticholinergic medications.
Vaginal estrogen.
Pessary (a small rubber device worn inside the vagina to prevent leakage).
Botox injection into the bladder.
Urethral bulking agents.
Peripheral nerve stimulation.
Fourth: Surgical treatment
Slings: They may 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 a greater risk of complications than other treatments, it may provide a long-term solution. Finding the best option for stress urinary incontinence surgery depends on the benefits and risks associated with each procedure, as well as your specific health and treatment needs.
Potential complications and risks
Like any surgical procedure, urinary incontinence surgery has its risks, although uncommon, including:
Temporary difficulty urinating.
Temporary difficulty emptying the bladder (urinary retention).
Development of overactive bladder.
Urinary tract infection.
Wound infection.
Difficult or painful sex.
Extrusion of surgical material into the vagina.
Pain in the thigh.
Finally, we recommend speaking to your surgeon about the potential risks and benefits of the surgical option.
Pre-operative suggestions
Before deciding on surgery and determining its type, the patient should take the following suggestions into consideration:
Get an accurate diagnosis. Different types of urinary incontinence require different treatments. A genitourinary doctor (or urologist) performs further diagnostic tests.
Understand that surgery only corrects the problem it was designed to treat. For example, surgery for stress urinary incontinence does not treat sudden, intense urges to urinate (overactive bladder), and mixed incontinence — a combination of stress urinary incontinence and 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 finished having children. The stress of pregnancy and childbirth on the bladder, urethra and supporting tissues may negate the benefits of surgical treatment.
Finally, we advise everyone who suffers from urinary incontinence: “Do not let urinary incontinence prevent you from enjoying life. Review, discuss and follow up with the urologist, as he will definitely give you appropriate solutions to live well with your condition.”
• Community medicine consultant
