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Urinary incontinence
What department should I go to for urinary incontinence?
Urinary incontinence refers to the involuntary leakage of urine from the bladder, uncontrollable. There are many causes of urinary incontinence, categorized into stress incontinence, overflow incontinence, urge incontinence, and functional incontinence. If urinary incontinence occurs, it is advisable to visit a urologist and undergo some related examinations. The most common type among female patients is stress incontinence. For instance, urine might involuntarily leak during coughing, sneezing, or lifting heavy objects. This is associated with weak pelvic floor muscles, impaired function of the bladder sphincter or urethral sphincter, lack of coordination among these muscles, and a deficiency of estrogen. Urge incontinence is mainly seen in urinary tract infections, whereas overflow incontinence can be seen in conditions like prostate enlargement, urethral stricture, or neurogenic bladder.
What causes urinary incontinence in the elderly?
Urinary incontinence in the elderly varies due to different mechanisms and types, with the two most common categories being genuine urinary incontinence, which is due to neurogenic bladder dysfunction or overactive detrusor muscles, damage to the urethral sphincter, or loss of bladder storage function. These are commonly seen in conditions like chronic stroke, dementia, Parkinson's disease, and psychiatric diseases. The other major category is caused by relaxation of the urethral sphincter or pelvic floor muscles surrounding the urethra, leading to reduced urethral pressure. Incontinence in this category may occur when negative pressure increases, such as during coughing, sneezing, straining during bowel movements, or changing body position. This type of urinary incontinence is more common in elderly women and in elderly men who have had prostate removal, leading to damage to the external urethral sphincter.
Will postpartum urinary incontinence heal itself?
Symptoms of urinary incontinence after childbirth are curable for most women. Postpartum urinary incontinence results from the relaxation and strain of the pelvic floor muscles during pregnancy and childbirth, thus it is necessary to exercise these muscles after giving birth. Additionally, pelvic physiotherapy can also be performed. Generally, normal function can be restored within six months, and for those in better health, recovery can occur as soon as one month postpartum. It is critical to adhere to treatment under medical guidance when experiencing urinary incontinence; otherwise, the impact on a woman's health can be significant, affecting normal social interactions and work.
How is stress urinary incontinence treated?
Stress urinary incontinence primarily occurs when activities like coughing, sneezing, lifting heavy objects, or jumping rope cause a sudden increase in negative pressure, leading to urine leakage from the urethral opening. For the treatment of stress urinary incontinence, it is important to determine the severity of the condition. For mild stress urinary incontinence, improvement can be achieved through exercises that strengthen the urinary sphincter and the pelvic floor muscles. For moderate to severe stress urinary incontinence, surgical intervention is recommended, mainly through mid-urethral sling procedures to manage urination. Patients should also take care to minimize activities that suddenly increase abdominal pressure, such as lifting heavy objects, laughing heartily, or sneezing.
What is the difference between genuine urinary incontinence and pseudo urinary incontinence?
Genuine urinary incontinence generally occurs due to incomplete closure of the urethral sphincter, or due to insufficient urethral closure pressure. As a result, patients will show continuous leakage of urine from the urethra or involuntary urine discharge from the urethra when there is an increase in intra-abdominal pressure, such as during sneezing, coughing, or performing strenuous physical activities. Genuine urinary incontinence includes both continuous and stress urinary incontinence. Pseudo urinary incontinence is generally due to urethral stricture, commonly seen with conditions such as prostatic hyperplasia or urethral stones. The urethral stricture prevents urine from being expelled from the bladder. When the bladder becomes overly full, urine overflows through the urethra, a condition also known as overflow incontinence.
How to recover from urinary incontinence after natural childbirth
Vaginal delivery refers to childbirth through the vagina, and while it has many benefits, it also has certain drawbacks. The biggest disadvantage is that it can cause damage to a woman's pelvic floor, leading to conditions such as uterine prolapse and bladder prolapse, which manifest as urinary leakage or incontinence. If urinary incontinence occurs after vaginal delivery, it can be addressed through the following methods: First, one can perform Kegel exercises at home. Kegel exercises are a set of movements that contract the muscles of the pelvic floor, which can help alleviate urinary incontinence, though the effect may be weak. Second, for patients with significant urinary leakage or incontinence, it is recommended to seek hospital treatment with machine-assisted therapy, primarily using electrical stimulation of the pelvic floor muscles to promote contraction and improve symptoms of incontinence. Third, if the above methods are ineffective, an evaluation of pelvic floor function should be conducted, and if necessary, pelvic floor repair surgery should be performed.
Should I wear diapers for urinary incontinence?
Whether patients with urinary incontinence need to use diapers should be determined based on the severity of the incontinence. If it is only mild incontinence that does not affect normal work and life, it is not necessary to wear diapers. Regular urination schedules, along with exercises like pelvic lift and pelvic floor muscle training, can alleviate the condition. However, if the incontinence is more pronounced, it is best to initially use diapers to prevent excessive urine leakage. If necessary, a urinary catheter can be used temporarily to drain the urine and prevent leakage. At the same time, it is important to actively undergo relevant examinations to determine the cause of the incontinence and carry out targeted treatment.
Is urinary incontinence related to anything?
There are many causes of urinary incontinence. For example, the most common type, stress urinary incontinence, is related to the relaxation of the pelvic floor muscles and the bladder's detrusor muscle. Conditions like pelvic organ prolapse, as well as factors like being a mature mother or excessive obesity, can lead to stress urinary incontinence. Urgency urinary incontinence is often caused by severe bladder inflammation or associated with certain chronic diseases, such as diabetes or bladder neck sclerosis. Overflow incontinence, most commonly seen in elderly males, typically results from prostate enlargement that blocks the urethra, leading to urinary retention and consequently overflow incontinence. Therefore, to understand the specific causes of urinary incontinence, it is crucial first to differentiate the types of incontinence and combine this with the patient’s specific situation and related examinations for a clear diagnosis.
What medicine to take for fecal incontinence?
There are many causes of fecal incontinence, and it is first necessary to further clarify the cause. Most cases of fecal incontinence are mainly due to excessive relaxation of the local anal sphincter or damage to the patient's nervous system, thus requiring oral medication to treat the nervous system. When there is relaxation of the local anal sphincter, simply taking oral medication does not have significant local therapeutic effects. The most effective method is to directly perform a sphincter tightening surgery. After the local sphincter is tightened surgically, it can control the excretion of feces, thereby further alleviating the situation of fecal incontinence. If the patient also has a neurological disorder, it is necessary to actively treat the underlying disease. (The use of medications should be done under the guidance of a doctor.)
Can you sit for a long time with postpartum urinary incontinence?
When postpartum urinary incontinence occurs, it is not advisable for the mother to sit for extended periods. This is because urinary incontinence in women is primarily due to pelvic floor muscle dysfunction. Sitting for long periods is detrimental to the recovery of pelvic floor muscle function. It is recommended that women pay attention to rest, avoid prolonged walking or standing, and also avoid sitting for long periods. Rest is important, as is ensuring adequate sleep and enhancing nutrition by consuming foods rich in protein and vitamins. It is advised to seek early pelvic floor rehabilitation training at a hospital and to adhere to the rehabilitation exercises. Generally, good recovery can be achieved within six months.