Incontinence is a very common and extremely delicate problem that millions of people face, regardless of gender and age. Unfortunately, very often patients do not seek help from a doctor, trying to cope with the disease on their own.
Incontinence is not natural to the body. This is a disease that needs treatment. That is why it is worth learning more about the causes of the appearance and effective therapeutic methods that help to cope with the disease.
What is a disease?
Many people today are looking for information on the causes and treatment of urinary incontinence. But first, it’s worth getting acquainted with some of the anatomical and functional features of the urinary system.
As you know, urine is produced by the kidneys, from which it passes through the ureter into the bladder. As the fluid accumulates, the pressure on the walls of the bubble increases, which activates the nerve receptors - a person has a desire to empty himself. Normally, people can control the process, restrain urination for a sufficiently long time thanks to the work of the sphincters. But sometimes the process is disturbed - the urine can flow out on its own, without urging, or the urges can be so intense that the patient simply can not restrain himself.
Many people suffer from a similar problem. According to statistics, approximately 40% of women experience this problem after menopause. In men, a similar ailment is diagnosed 4-5 times less often, but the likelihood of its development should also not be ruled out. Many patients consider involuntary leakage of urine a natural process associated with the gradual aging of the body. This is a misconception - incontinence is a pathology that needs to be treated.
Urinary Incontinence: Causes and Risk Factors
Lack of control over urination can develop under the influence of many factors. The list of possible reasons is very impressive:
- According to statistics, women suffer from a similar pathology at times more often. This is due to some anatomical differences in the female genitourinary system.
- Risk factors include old age. For example, urinary incontinence in women after 50 years of age (as well as in men) is diagnosed much more often than in young patients. This is due to developing muscle and ligament weakness in the pelvis, as well as a change in hormonal levels. For example, the representative of the fair sex after the onset of menopause significantly decreases the level of estrogen, which affects the structure of muscle and connective tissue.
- Urinary incontinence in men often develops against a background of problems with the prostate gland (for example, chronic prostatitis, adenoma, the formation of malignant tumors).
- Risk factors include obesity. Being overweight creates additional pressure on the pelvis, which leads to displacement of organs, stretching of muscles and ligaments.
- It is believed that the likelihood of a similar problem increases with smoking.
- Nutrition and drinking are important. For example, foods and drinks such as chocolate, tomatoes, coffee, alcohol irritate the mucous membrane of the bladder, which, if there are some other factors, can lead to incontinence.
- Often develops urinary incontinence in women after pregnancy and childbirth. The fact is that fetal growth leads to displacement of the pelvic organs, sprain, weakening of the muscles. In addition, tissue is often injured during childbirth, which also results in problems with urination.
- Various neurological disorders that occur, for example, against the background of multiple sclerosis or as a result of a stroke, can also cause incontinence.
- There are a number of other diseases that, in certain situations, can lead to impaired urination. Their list includes diabetes mellitus, kidney disease, chronic constipation, urinary tract infections, damage to the peripheral nerves and spinal cord.
- Urinary incontinence can be a side effect of taking certain drugs, in particular, adrenergic blocking agents, hormones, diuretic drugs, etc.
- There is a certain genetic predisposition.
- The disease sometimes develops after undergoing surgical procedures on the pelvic organs.
- Problems arise due to some diseases of the genitourinary system, if the formation of scar tissue is observed against their background.
- Incontinence in women 50 years of age and older may be associated with partial or complete prolapse of the internal organs of the reproductive system.
- The ailment may be associated with radiation exposure.
Stress incontinence: clinical features
Stress incontinence is indicated if urination occurs involuntarily during tension of the abdominal wall and an increase in intra-abdominal pressure. For example, such episodes occur during coughing, loud laughter, sneezing, lifting weights. At the same time, there is no urge to empty the bladder - just a small amount of urine is released.
Stress incontinence is most often associated with a weakening of the muscles of the pelvic floor and a decrease in collagen levels in the ligaments. In most cases, women face a similar problem.
Urgent form of the disease
The urgent (imperative) form of the disease is also considered widespread. In this case, the urge to empty occurs, but is imperative. The patient has an irresistible need to urinate, and immediately. It is almost impossible to resist or at least slightly delay urination.
An imperative urge may occur after leaving a warm room in the cold. The sound of flowing water or the influence of other environmental factors can provoke urination. In any case, the patient cannot control the urination process, which leads to a host of social complications (a person is literally afraid to go out, receive guests, and communicate with people).
Functional incontinence
Sometimes the ailment is in no way associated with a violation of the structure of the genitourinary system - all organs retain functional properties, but still can not control urination. The causes of urinary incontinence in this case may be as follows:
- progressive Parkinson's disease;
- Alzheimer's disease, dementia and other forms of dementia;
- severe depression and some other mental disorders.
Other types of incontinence
There are other forms of urinary incontinence, cases of which are also often recorded in modern medical practice.
It:
- Nocturnal enuresis - involuntary urination during sleep. Most often children suffer from such a pathology.
- Syndrome of a neurogenic bladder, in which the innervation of the urination organs is impaired (the patient simply does not feel the urge and, accordingly, does not have the ability to control them).
- Iatrogenic incontinence develops while taking certain drugs.
- Overflow incontinence (paradoxical) is associated with overflow and subsequent overstretching of the bladder. This form of the disease is usually associated with a violation of the normal outflow of urine against the background of prostate adenoma, cancer, urethral stricture, etc. In most cases, such urinary incontinence develops after 50 years.
- A mixed form of the disease is also possible, which combines the symptoms of imperative and stress incontinence.
In the process of diagnosis, it is very important to determine the form of the disease and the causes of its occurrence. Only in this way will the doctor be able to draw up a truly effective treatment regimen.
Possible complications
This is a very common problem that millions of people face, especially in adulthood, after 50 years. Urinary incontinence in the absence of treatment can lead to unpleasant, and sometimes dangerous complications:
- According to statistics, a violation of the outflow of urine, fluid congestion, a change in the structure of the genitourinary organs increases the risk of developing cystitis, urethritis, pyelonephritis and other diseases.
- Urine excreted, as a rule, comes into contact with the skin, irritates delicate tissues in the perineum and on the inside of the thighs. Gradually, the skin turns red, diaper rash appears on it. Pathological processes often lead to the development of dermatitis, the risk of infection of tissues by pathogenic bacteria and fungi increases.
- Of course, urinary incontinence simply cannot but affect the patient’s emotional state. Inability to control one’s own bladder forces a person to change their lifestyle. People suffering from a similar problem become closed, experience problems with communication, sex life, etc. There is a decrease in working capacity, the development of various neuroses and depressive states.
Naturally, timely treatment (including surgery) and the right lifestyle can minimize the likelihood of complications. That is why in no case should you give up medical care.
Diagnostic procedures
The appearance of a similar problem must be reported to the doctor. Correctly performed diagnostics are extremely important. The specialist must determine the cause of the disease (for example, urinary incontinence in the elderly can be caused by other reasons than the same problem in young patients).
- First, a general examination and collection of data for the anamnesis is carried out. The doctor will ask questions about previous illnesses, lifestyle, daily habits. Surely a specialist will ask you to keep a diary of urination.
- Also, the patient takes blood and urine tests - this makes it possible to detect the existing inflammatory process.
- Using a soft tube and a special catheter, the volume of residual urine is measured (normally this figure should not exceed 50 ml). The same procedure can be performed using an ultrasound scanner.
- Informative is cystometry. During the procedure, the doctor can determine the maximum volume of the bladder, as well as the pressure that the walls of the organ can withstand.
- Uroflowmetry is a procedure that allows you to measure the flow rate of urine.
- Cystoscopy is also mandatory. This is an endoscopic procedure, during which the doctor carefully examines the inner surface of the bladder using special equipment in order to detect certain deviations (for example, the appearance of neoplasms, scar tissue, etc.).
- Electromyography is performed if there is a suspicion of impaired conduction in nerve fibers. During the procedure, special sensors are used that measure the electrical activity of muscles and nerves around the sphincter of the bladder.
Drug treatment
Immediately it is worth saying that the treatment of urinary incontinence must be comprehensive. Therapy includes both medications and other techniques.
According to statistics, the drugs used in modern medicine are most effective for imperative forms of the disease. Treatment in this case is aimed at relieving muscle cramps, normalizing nerve conduction:
- Anticholinergics help relieve spasm from the muscle walls of the bladder, thereby increasing its volume. Medications help to cope with the frequent urges that appear even before the moment the bubble is full.
- Treatment for urinary incontinence in men sometimes occurs with alpha blockers. Such drugs provide relaxation of smooth muscles, and also help to cope with prostate adenoma (an enlarged prostate is often the cause of incontinence).
- Antidepressants sometimes help to cope with imperative urges.
- If the violation of urination is associated with menopause, then women can be prescribed hormonal drugs.
Non-drug therapies
Drug treatment of urinary incontinence can reduce the manifestation of some symptoms, but, unfortunately, it can not completely eliminate the problem. That is why several other procedures are included in the treatment regimen:
- Kegel exercises are required. Such physical education helps to strengthen the muscles of the pelvic floor, improve blood circulation, eliminate stagnant processes. The exercises are simple, therefore accessible to people regardless of gender and age. They need to be repeated daily.
- Effective urination training. Its essence is simple: feeling the urge to empty, you need to try to restrain them for at least a few minutes. In the future, the interval between urination should be gradually increased. Ideally, the patient manages to schedule an emptying and clearly follow it.
- Coffee, cocoa, alcohol, spices and spices should be excluded from the diet, as these products irritate the wall of the bladder and provoke its uncontrolled emptying.
Urinary incontinence: surgery
When it comes to mild incontinence, then exercise and a small lifestyle correction will be enough to fix the problem. But sometimes the only way out is surgery.
- In most cases, the installation of special slings is carried out, which normalize the processes of urination, relieve pressure from the walls of the bladder.
- In more severe cases, Birch surgery is performed. This is a full cavity procedure, which involves the attachment of the upper part of the vagina to the abdominal wall by surgery.
- If there is a malfunction of the sphincter, then the patient can have an internal implant (a kind of cuff on the urinary canal), which is controlled using a special pump. In most cases, artificial sphincters are established for men who have undergone surgical removal of the prostate gland.
- Sometimes the doctor introduces special dry mixtures into the area of the sphincter and urinary canal, which contain collagen. The mixture helps to add volume to the surrounding tissues, make the sphincter more elastic and resilient.
- If there are neurological disorders, then patients are sometimes recommended sacral stimulation (stimulation of the sacral nerves). A special device is installed in the sacral region, which normalizes the processes of transmission of nerve impulses to the bladder and in the opposite direction.
Treatment with folk remedies
It’s worth saying right away that home remedies can only be part of adjuvant therapy - they are not able to completely eliminate incontinence or eliminate the cause of its appearance.
- Some folk healers recommend drinking dill broth daily. To prepare it, you need to fill a tablespoon of dill seeds in a thermos, pour everything with a glass of boiling water, close the lid and insist for two hours. Next, the resulting mixture is filtered and drunk.
- Effective is a decoction of St. John's wort and lingonberry leaves. Tea is prepared from a mixture of dried herbs, which is consumed daily (can be slightly sweetened).
- You can make an infusion of corn stigmas. A teaspoon of raw materials is poured with a glass of boiling water, covered with a lid and insisted for 15 minutes. The mixture is then filtered and drunk.
Of course, self-medication in this case is not worth it. If you still decide to take home-made medicines, you must first consult a doctor.