Urinary incontinence A symptom thatThe patient is unable to control his bladder. Causing the urine to come out accidentally Patients may feel sickYesurineSo much thatNot holding back Or may occur while coughing and sneezing It is more common in women than in men. Some patients may haveTemporarily While some may have long-term effects. The nature of the symptoms will also depend on the disease or health problem that is causing it. In which the doctor will provide treatment according to that cause
Symptoms of urinary incontinence Divided into several categories as follows
Urinary incontinence when there is pressure This creates pressure around the bladder, causing urinary incontinence. This may be caused by coughing, sneezing, laughing, exercising, lifting heavy objects. Other physical movements Or have conditions that result in physical changes such as pregnancy, childbirth and being in menopause In which patients often have little urine leakage But if the bladder is full at that time, it can cause a lot of urine to leak out.
Urinary incontinence due to overflow Or symptomsNot urinatingChronic occurs when the patient is unable to urinate completely. Because the bladder muscles are weak or may cause a blockage of the urethra. Which may be caused byEnlarged prostate There are stones in the bladder or constipation.Causing more residual urine than normal The patient may excrete only a small drop of urine and feel unable to pass out completely.
Pouring urine It is a sudden, painful urination that you cannot hold. Some people may urinate often without exception even at night. Some factors may stimulate urination such as hearing the sound of running water. Or a sudden change in posture, etc., as well as may urinateDuring sex or when you have orgasm Which is mostly caused by overactive bladder Or it could be caused by an infection Neurological disorders And diabetesAs well
Incontinence Caused by psychological or physical disorders that result in the patient being unable to go to the toilet, for example, the patient has severe arthritis symptoms that may cause urinary incontinence due to illness causing slow removal of pants, etc.
Urinary incontinence for a variety of reasons Patients may have more than one common symptom of urinary incontinence, such as urinary incontinence when coughing or sneezing, along with chronic urinary incontinence. Or pain, sudden urination and unable to hold it, etc.
Causes of urinary incontinence
Urinary incontinence can arise from lifestyle habits. Illness Or some changes that occur in the body as follows
Diet and drug use
- Eat certain foods or beverages, such as alcohol, soft drinks, sugars, chocolate, peppers, citrus fruits. Foods with high amounts of spices, sugar, or acidic foods, etc.
- Taking certain medications, such as antidepressants High blood pressure medication Muscle relaxants Hormone replacement diuretics, etc.
- Pregnancy due to changes in the hormones in your mother’s body As well as increased fetal weight, it may cause urinary incontinence during this period.
- Give birth because the muscles that control the bladder may weaken, causing the pelvic muscles to loosen. It also causes the bladder, uterus, colon and small intestine to move into the vagina. Which may cause the patient to have symptoms of urinary incontinence as a result
- Through a hysterectomy The pelvic floor muscles can become damaged and affect the bladder.
- Are elderly or are in menopause As it ages, the muscles of the bladder become altered and have less fluid in the urine. As for women in menopause The body produces less estrogen. This hormone helps keep the lining in the bladder and urethra strong, so as less of this hormone is produced, these tissues deteriorate and result in urinary incontinence.
- Urinary tract infection This can cause the bladder to become irritated and have pain, urinating abnormally heavy or incontinence.
- Have bladder problems, such as persistent urinary incontinence due to tumors Bladder perforation Have stones in the bladder etc.
- Constipation because the anus is close to the bladder and has many nerves together. When the stool accumulates, it may stimulate the nerve function in that area. This can affect the bladder as well.
- Have prostate problems, such as an enlarged prostate Prostate cancer, for example, or may be a side effect from prostate cancer treatment as well.
- Having a neurological disease such as multiple sclerosis Parkinson’s disease Cerebrovascular disease Brain tumor Or spinal cord injury, for example, because these diseases can affect the nerve signaling involved in bladder control.
Diagnosis of urinary incontinence
The doctor will ask about the patient’s symptoms. Health history taking And physical examination to assess initially what type of urinary incontinence is Then further diagnosis may be made as follows.
Take note of urination By having the patient record continuously for several days To know the daily water intake and the amount of urine that is excreted. Including seeing if there is pain, urination, abnormality or urinary incontinence or not.
Urine test The doctor will take a sample of the patient’s urine and culture it to check for bacterial infection. The formation of stones in the urinary tract Or any abnormalities, and may use urine test strips to check the levels of blood and protein in the urine
Check the amount of urine remaining in the bladder. If the patient is assumed to be unable to hold urine due to overflow Your doctor may check the amount of urine remaining in your bladder after urinating. An ultrasound is used to visualize the bladder. Alternatively, a catheter may be inserted into the urethra to measure the amount of urine.
Check the function of the urinary system It is a pressure measurement tube inserted into the urethra. To measure pressure on the bladder or abdomen The doctor then puts the patient to urinate into a device intended to measure urine volume and flow.
Examined by stimulating force The doctor will give the patient a strong cough. During this time, your doctor will examine your urethra and the amount of urine that is being emitted.
Examined by urinary tract endoscopy It is the introduction of a tube with a small camera inserted into the urethra. This allows the doctor to see the bladder and urethra. In order to identify abnormalities that occur to the patient.
Treatment for urinary incontinence
The doctor will consider treatment based on symptoms. The severity of the illness Including the disease that causes it Which may require a combination of treatments The methods that doctors may adopt are as follows.
Advising patients to modify behavior
- Provide exercise to train the pelvic floor muscles. Patients may consult a physical therapist about exercise planning. Or may train the knees for 5 seconds and then relax for 5 seconds, do 10 times as a set. And should practice 3 sets per day, which exercise in this way on a regular basis will make the muscles stronger and able to control urination.
- Eat a healthy diet and avoid caffeinated beverages. In addition, adjust the amount of beverages the patient consumes each day as recommended by the physician. Because if you drink too much or too little, your symptoms can worsen.
- Practicing urination, such as practicing to slow down urination They should hold their urine for about 10 minutes when they feel pain before urinating. Try to urinate repeatedly to help empty your bladder and reduce the incidence of overflow. Or rushing to the bathroom first, the pain will urinate so much that you cannot hold it, etc.
- Take care of your health by keeping your weight within the proper limits.
The doctor may advise the patient to take certain medications. To help the muscles in the bladder relax, squeeze less body and make it easier to urinate. Or help to hold urine for longer, for example
- Anti-colineric drugs
- Mirabegron drug
- Alpha blockers
- Anti muscarin
- Hormone replacement drugs
- Surgery to put a sling under the urethra To help cover the urethra to prevent urinary incontinence if the patient coughs or sneezes.
- Surgery to treat pelvic floor prolapse It is often used in women with urinary incontinence and pelvic prolapse. The doctor may use this method in conjunction with the urethral sling surgery.
- Artificial sphincter surgery It is an operation for male patients. The doctor will implant a loop of fluid around the neck of the bladder. To keep the urethra sphincter closed all the time. When you need to urinate The patient presses a button under the skin to flatten the loop until urine can flow out.
- Urinary catheter surgery through the abdomen The tube is inserted through the abdominal surgery hole to drain urine through the tube.
- Electric stimulation The doctor will insert electrodes into the vagina or colon. To stimulate the pelvic floor muscles And makes the muscles in those areas more strong
- Use a medical device like urethral insert, which looks like a tampon. By inserting it into the urinary tract To prevent the flow of urine Before the patient will urinate, the device must always be removed.
- Botox injectionsInto the bladder muscle area To help reduce symptoms of overactive bladder squeezing This method will be used with patients who have failed other treatments.
Complications of urinary incontinence
Various complications can arise in people with urinary incontinence or incontinence. With possible urinary tract infections Or a problem with the skin such as an infected skin rash Caused by wet wounds in the hidden spots, etc. In addition, it may affect life. May make the patient feel embarrassed when urinating incontinence. And may affect work Relationships with other people, including social life
Preventing urinary incontinence
Although unable to prevent all symptoms of urinary incontinence But may reduce the risk as follows
- Exercising and exercising your pelvic floor muscles, especially in those who are pregnant or have recently given birth.
- Weight control Because obese or overweight patients may be at risk of urinary incontinence. Therefore, exercise and a healthy diet should be exercised to maintain optimal body weight.
- Avoid alcoholic beverages And caffeinated beverages such as tea, coffee or soft drinks, as well as no smoking Because these factors may cause the kidneys to produce more urine. And may cause irritation to the bladder