Urinary incontinence in women
Urinary incontinence in women is called a state in which there is an involuntary leakage of urine. Urinary incontinence is divided into overflow incontinence, anatomic incontinence, functional incontinence, and total incontinence.
About 20% of women involuntary leakage of urine occurs between the ages of 20 to 55 years, 15% women - 35 years, 28% - after 55 years.
Symptoms and causes of urinary incontinence in women
There are two main causes of urinary incontinence. Urinary incontinence can occur when pressure on the bladder at the time of laughing, sneezing, coughing and other activities. Urinary incontinence caused by stress, does not appear in a dream and a change in body position.
The cause of urinary incontinence in women may be an uncontrollable urge to urinate occurs when involuntary contractions of the bladder muscles.
Urinary incontinence may be due to failure of the pelvic floor. After the trauma of the pelvic floor uterus, bladder and vaginal wall fall, changing its natural location. Urinary incontinence can be caused by hereditary factors, a variety of anatomical disorders (congenital and acquired), surgery, hard labor, urinary infections, taking some drugs, are overweight.
The disease can develop gradually with stones in the bladder, pelvic organ prolapse, diabetes, Alzheimer's disease or Parkinson's disease, multiple sclerosis, bladder cancer, stroke, spinal cord injury, and after undergoing a hysterectomy (removal of the uterus) and chronic cough associated with smoking or prolonged course of bronchitis.
Urinary incontinence can develop at smoking, insufficient fluid intake and caffeine abuse.
The symptoms of urinary incontinence
Incontinence in women urgent need to urinate variable. Symptoms of urgency may vary depending on the specific situation and lifestyle. However, all the symptoms are always retained an uncontrollable desire to urinate. Increased urination occurs at night. If frequent urination condition of the patient deteriorates, as the bladder is no longer keeps a large amount of urine.
The urge to urinate incontinence may occur even with a nearly empty bladder. A small amount of urine stream flows, high flow or drops. Urine happens when running, walking, in bed, at the sound of running water from the tap. Neurogenic incontinence manifests itself in excessive stretching of full bladder. When the bladder is fully filled, the fluid pressure overcomes the resistance of the sphincter and urine leaking from the bladder. In this type of violation of women are unable to urinate normally strong steady stream.
Methods of diagnosis and treatment of urinary incontinence in women
To clarify the diagnosis of urinary incontinence in women doctor specifies the details of the disease and conducts a physical examination. The presence of infection in the bladder helps determine seeding for sterility, urinalysis and urine culturological. To carry out the stress test for the bladder, the doctor inserts liquid into the bladder, and requests cough. And Bonnie lifting test (stretching) the bladder neck comes with a tool or finger introduced into the vagina. The test pads helps determine how often and how much urine leakage occurs during the day.
Additionally incontinence doctor may prescribe tsistometrografiyu cystometry, uroflowmetry - a series of tests to determine the pressure in the bladder at a different filling. When cystometry determine the pressure leakage and maximum compressive strength of the urethra. Determine residual amount of fluid in the bladder after micturition helps method and ultrasonic diagnostic radiography. They help determine the position of the urethra and bladder stress, coughing and urinating.
Individual patients prescribed cystoscopy - a method for studying the internal structure of the bladder and urethra using a thin endoscope. Identify the physical defects of the urinary system helps cystourethrogram. In this method for X-ray the inner walls of the urethra and bladder used iodine-containing contrast.
For the treatment of urinary incontinence in women, there are many approaches. The best therapies are based on the fight against the cause of urinary incontinence. And depending on the cause of violations apply physiotherapy, exercise, hormone therapy, medication, psychotherapy or surgical therapy. The state of health can be improved with the replacement of one drug from the urinary incontinence in women to another, while eliminating the pathological condition of the underlying disorder.
With any type of urinary incontinence in women to help cope Kegel exercises. These exercises help strengthen the muscles of the abdomen and pelvis. When you exercise the patient should be three times a day for three seconds to strain the pelvic muscles. The effectiveness of a pessary, special rubber intravaginal devices depends on the type of incontinence and the individual characteristics of the anatomical structure of the body.
To strengthen the pelvic muscles is possible using extracorporeal magnetic stimulation. During this procedure, a magnetic field acts on the nerve endings of the body.
Urinary incontinence during physical exertion, but without weakening the muscles of the pelvic floor, vaginal atrophy treated with various drugs (eg, decongestant and decongestant Zyudafed). It is believed that some drugs on urinary incontinence in women are able to provide life-long therapeutic effect.
If incontinence is caused by omission or uterine prolapse, you can not do without surgery. Operation incontinence in women, and can eliminate the fistula, which may cause incontinence.
Operations incontinence in women is carried out either chrezvaginalnym or transperitoneal access under general anesthesia. In extremely severe cases of incontinence treated by increasing the bladder or urinary diversion.