Incontinence in women is an extremely unpleasant and very delicate problem that requires treatment. Such a violation can have various reasons. If untreated, the pathology progresses and is much more difficult to treat.
That is why many people today are looking for additional information. What is a pathology? Why does urinary incontinence so often develop in older women? What are the most effective therapies? The answers to these questions are important.
What is a pathology?
Urinary incontinence is a common problem that is associated with uncontrolled secretion of fluid. At the same time, there is no natural urge to empty the bladder, and a person is not able to control the process of urination.
It is worth noting that such a violation is not an independent ailment, but only a manifestation of other pathological processes. By the way, not only children are faced with this problem. If we talk about patients 40-50 years old, more often recorded incontinence in women. Scientists attribute this to the anatomical features of the body. But in the age group of patients older than 60-70 years, men predominate (incontinence is often one of the symptoms of prostatitis).
Classification
In modern medicine, there is a classification scheme.
- True incontinence is a condition in which urine flows involuntarily from the bladder, and the patient does not have any violations of the anatomical integrity of the urinary tract.
- If it is a false form of incontinence, then urine is excreted due to the presence of congenital or acquired anatomical defects of the urinary system (for example, this is observed in the presence of fistulas, epispadias of the urethra).
Incontinence in women: causes
Unfortunately, many people face similar problems. What to do if women have urinary incontinence? The causes and treatment in this case are closely related, so you should familiarize yourself with their list.
- First of all, it's worth talking about anatomical abnormalities and local sensory impairment. The fact is that obesity, complicated and / or repeated births, previous surgical interventions, and also some sports (for example, weight lifting) can reduce the sensitivity of nerve receptors and change the position of organs in the pelvis. This often leads to incontinence.
- To the list of reasons include changes in the level of hormones. For example, urinary incontinence in women after 50 years is often associated with menopause, namely, a decrease in estrogen levels. Against the background of a deficiency of this hormone, there is a gradual atrophy of the ligaments and muscles in the pelvic floor, as well as changes in the membranes of the organs of the genitourinary system, which leads to a violation of the outflow of urine.
- Mechanical injuries of the pelvic organs, spinal cord, and brain are also considered potentially dangerous.
- The cause may also be some diseases, in particular diabetes mellitus, circulatory disorders, multiple sclerosis.
Stress incontinence and its features
When talking about stress urinary incontinence, they mean the inability to control the process of urination against the background of physical stress. A similar pathology is accompanied by very characteristic symptoms. Urine is excreted during coughing, laughing, intercourse, running, jumping, that is, with tension of the abdominal muscles.
In the initial stages, urination occurs only when the bladder is as full as possible. But as the disease develops, even a light sneeze is accompanied by the release of urine. It is worth noting that there is no peremptory urge to urinate in patients.
There are many reasons that can lead to the development of stress incontinence, including:
- difficult birth, especially if they were accompanied by rupture / cutting of the perineum;
- previously performed operations in the pelvic area;
- the formation of fistulas between the organs of the urinary system;
- hormonal disorders;
- obesity, especially if it is associated with diabetes;
- sudden loss of body weight;
- intense physical activity;
- prolapse of the pelvic organs, in particular the uterus;
- constant lifting of weights;
- recurrent urethritis, cystitis;
- neurological pathologies, injuries of the brain and spinal cord;
- chronic constipation;
- chronic diseases of the respiratory tract, which are accompanied by frequent severe coughing.
It is proved that representatives of the Caucasian race are more prone to the development of this type of disease. A certain role is played by genetic heredity.
Urgent form of incontinence
Quite common is urgent (imperative) incontinence. This form of the disease is associated with impaired transmission of the nerve impulse to the muscles of the detrusor of the bladder, and this is accompanied by its uncontrolled contraction.
The urge to urinate is imperative. They occur instantly, and it is almost impossible to restrain the process of emptying the bladder. This does not happen at full (this happens during normal functioning of the body), but with partial filling of the bladder with urine. Desires become more frequent - patients often wake up even at night. If bladder prolapse occurs, pain and discomfort in the lower abdomen may occur.
Iatrogenic incontinence
Iatrogenic urinary incontinence in women is associated with taking medications. The fact is that incontinence can be a side effect that develops against the background of the use of a number of drugs, including:
- adrenomimetics, in particular pseudoephedrine, which are used to treat bronchial diseases (first, these drugs lead to urinary retention, and then to urinary incontinence);
- hormonal agents in which estrogen is present;
- adrenergic blockers;
- some antidepressants;
- "Colchicine" used in the treatment of gout;
- some sedatives.
It is worth noting that not in all cases, therapy with these funds is accompanied by incontinence. Since this is just a side effect, the problem usually disappears by itself at the end of the course of treatment.
Other types of disease
Incontinence in women may look different. There are other types of pathology that are worth mentioning.
- With a mixed form of the disease, the features of stress and imperative incontinence are combined. By the way, more often women after 50 years suffer from such an ailment.
- Paradoxical incontinence is associated with too much filling and overstretching of the bladder, which leads to leakage of urine. A similar condition is observed against the background of stricture of the urethra, adenoma or prostate cancer.
- Transient incontinence develops against a background of chronic constipation, acute cystitis, severe intoxication. This is a temporary violation that disappears after eliminating the causes.
Diagnostic measures
A woman can determine the presence of urinary incontinence on her own. The diagnostic task in this case is to find the cause of the problems of the urinary system.
- the patient is recommended to keep a urination diary for several days, carefully recording all incontinence cases and describing the situations in which they occur;
- gynecological examination is mandatory;
- cystoscopy is sometimes performed (examination of the inner surface of the walls of the bladder using a cystoscope);
- urodynamic research (special sensors are introduced into the bladder that record and record information about the functioning of the organ);
- An additional ultrasound of the pelvic organs is performed.
Urination exercise
In today's world, unfortunately, it is not uncommon for women to have urinary incontinence. The treatment in this case includes training to urinate. This is a relatively new but effective technique. Its essence is to adapt the body to empty the bladder according to the schedule. Initially, a minimum interval is allowed between two acts of urination - it is imperative that the patient tries to restrain the flow of urine until the right time. The interval is gradually increasing.
Non-drug therapies
How to treat urinary incontinence in women? It should immediately be said that the therapy process must be complex, and sometimes it takes a lot of time. Doctors say that therapeutic gymnastics has a positive effect on the patient's condition. In particular, Kegel exercises help strengthen muscles and ligaments in the pelvic area, which prevents the development of stagnant processes and helps to fix the position of organs.
In addition, patients are sometimes prescribed physiotherapy. Useful effects are considered microcurrents, electromagnetic pulses, as well as heating. Such techniques can make ligaments and muscles more elastic, normalize the blood supply to the organs of the genitourinary system.
Incontinence in women: medication treatment
The treatment regimen is determined individually. What activities does urinary incontinence in women require? Treatment with pills is possible, especially when it comes to imperative urges.
As a rule, patients are prescribed antispasmodics and antidepressants. Such drugs as Driptan and Oxybutin are considered effective. Such drugs block irregular impulses from the central nervous system, while relaxing the bladder detrusor. Therapy, as a rule, lasts about three months, the dosage and schedule of admission are individual.
Surgical intervention
Unfortunately, conservative therapy is not always possible to cope with such a problem as urinary incontinence in women. The operation at the same time helps to eliminate anatomical defects and normalize the genitourinary system. Of course, the technique is chosen depending on the causes of enuresis.
- Sling surgery is a minimally invasive procedure that involves fixing a special loop under the neck of the bladder. This device supports the urethra and prevents the flow of urine.
- Sometimes drugs are introduced into the urethra that contain special substances to fill the soft tissue deficiency. The urinary canal becomes more elastic and maintains its position.
- With the omission of the pelvic organs, colporaphia is performed (partial stitching of the vagina).
It is worthwhile to understand that any surgical intervention is fraught with risk and has a number of contraindications. Moreover, there is always a risk of relapse. Nevertheless, in most cases, problems with urination can be eliminated.
Alternative methods of treatment
In medical practice, urinary incontinence in women after 50 is often recorded. Treatment in this case can be supplemented with folk remedies.
- Experienced herbalists recommend introducing into the daily diet tea with plowed clover grass (dry raw materials can be purchased at the pharmacy).
- Honey water can give a good effect. Preparing it is simple: you just need to dilute a teaspoon in 100 ml of warm water. It is important to drink the medicine daily, preferably before bedtime. Honey holds fluid in the body, which helps to cope with the flow of urine.
- Dill seeds are also considered useful, which are brewed in boiling water (a small amount of seeds) and drunk in a glass daily.
Of course, the remedies offered by traditional medicine can in no way replace medical therapy and surgical intervention. You can take your own medicine only with the permission of a doctor.
Problems and forecasts
Permanent urinary incontinence significantly worsens the patient’s quality of life, makes social life impossible and gradually leads to the development of various complexes and psychoemotional disorders. The causes of incontinence are overweight, anemia, diabetes, strict diets, and physically hard work.
But even so, a very small percentage of women turn to a doctor for a similar problem because of false shame or prejudice. For such patients, the prognosis is not very favorable, because incontinence often indicates more serious diseases that need to be treated. Therapy is possible and gives good results - we are talking about both conservative treatment and surgery. That is why it is worthwhile to consult a doctor when the first alarming signs appear.