Urinary incontinence


Can fecal incontinence be recovered?
If fecal incontinence occurs, the first step is to identify the main cause of the fecal incontinence. If it is caused by relaxation of the anal sphincter and anal canal, then surgery can be performed to tighten this area, specifically through an anal tightening procedure, which can restore control over fecal incontinence. If the patient has other underlying diseases or is elderly and frail, accompanied by changes in the nervous system, the symptoms of fecal incontinence may be alleviated through medication or physical therapy, but complete recovery is unlikely. This is because the recovery of the nervous system requires the integrated regulation of other bodily organs and functions. If there are multiple underlying diseases or if the patient is elderly and frail, especially in the later stages of coma, recovery is difficult.


What causes postpartum urinary incontinence?
Postpartum urinary incontinence in women often occurs after vaginal delivery. Clinically, postpartum urinary incontinence is relatively common and is mostly due to the stretching or injury of certain muscle groups in the pelvic floor as the baby passes through the birth canal during delivery. This can also occur due to surgical intervention affecting the nerves and blood vessels that support the pelvic floor, leading to relaxation or atrophy of the levator ani muscle. Postpartum urinary incontinence typically occurs about a week after delivery, and timely treatment is necessary. During the treatment period, bed rest is advised, which can alleviate some of the discomforts and possibly avoid the need for surgery.


Can fecal incontinence be cancer?
The most common causes of fecal incontinence are neurological dysfunction or relaxation of the local anal sphincter. In some cases of advanced rectal cancer, excessive tumor growth can enlarge the local intestinal contents, leading to involuntary expulsion of feces. Diagnosis involves further examination using electronic colonoscopy, digital anal examination, and assessment of neurological function. If the cause is related to a neurological disorder, treatment by a neurologist is required. If the cause is relaxation of the anal sphincter, then anal sphincter tightening surgery may be considered. In cases where fecal incontinence is caused by an intestinal tumor, surgery to remove the tumor is recommended, along with radiation or chemotherapy.


Urinary incontinence includes three types: stress incontinence, urge incontinence, and overflow incontinence.
Urinary incontinence, in clinical terms, is divided into the following categories: First, there is urge incontinence, where the main symptom is that as soon as one thinks of urinating, the urine comes out uncontrollably. This is commonly seen in urinary tract infections, among other conditions. Second, there is overflow incontinence, also known as pseudo-incontinence, which is actually due to an obstruction in the lower urinary tract, leading to an overfilled bladder that naturally overflows, causing involuntary urination. Third, there is true incontinence, which occurs because the mechanism controlling the urinary tract is damaged, resulting in leaks as soon as there is a small amount of urine in the bladder. If urinary incontinence occurs, it is recommended to visit a hospital. First, a routine urine test should be conducted; second, a color Doppler ultrasound of the urinary system should be performed, which can be done while holding urine or during routine times; lastly, a urodynamic test should be carried out to examine bladder function and determine the type of urinary incontinence.


What should be noted for fecal incontinence?
Patients with fecal incontinence should first pay attention to the cleanliness and hygiene of the anal area. Due to fecal incontinence, there will be fecal residue around the anus, so it is important to clean up promptly when there is fecal residue. Since feces contain certain irritating substances, these can irritate the skin around the anus, causing pain, eczema, or even provoking bedsores. Therefore, patients with fecal incontinence must frequently change positions, clean regularly, and further carry out local treatment. The most common cause of fecal incontinence is relaxation of the anal sphincter. If it is confirmed that it is due to the aforementioned reason, an anal constriction surgery can be chosen to tighten the local sphincter, thereby preventing the feces from being expelled abnormally from the anus. It could also be due to the patient being elderly and frail, with a nervous system disorder, and the primary disease needs to be actively treated.


What to do about urinary incontinence in dementia in the elderly?
Dementia in the elderly is a degenerative neurological disease, and there are currently no particularly effective treatments. In the later stages, it is very common for the elderly to experience urinary incontinence. This is mainly because in the later stages, the autonomic nervous system is affected. Damage to the autonomic nerves leads to dysfunction of the sphincter muscles, resulting in urinary incontinence. Currently, there are no particularly good treatments for urinary incontinence caused by dementia, but some common methods are as follows. First, it is important to kindly remind and encourage the elderly to go to the bathroom frequently, asking every one to two hours whether they feel the need to urinate, which can help avoid urinary incontinence. Second, bathrooms must have conspicuous signs that are prominently placed to help the elderly locate the restrooms easily. Third, when necessary, the elderly can be given diapers to wear to avoid embarrassment from wetting their pants. Also, it's crucial to provide psychological comfort to the elderly and avoid causing them excessive psychological burden. Additionally, other causes must be ruled out. If there is a urinary tract infection or some other urinary system disease causing the incontinence, treatment of the primary disease should be undertaken.


Can spinal inflammation urinary incontinence be cured?
Patients with myelitis often experience urinary incontinence because the condition affects the function of the autonomic nerves, which primarily govern the control of urination and defecation. Symptoms may include urinary incontinence, urinary frequency, or urinary retention. To treat urinary incontinence, it is first necessary to treat acute myelitis. Treatment must be timely, involving the administration of corticosteroids to suppress the inflammatory response and promote recovery from myelitis. Additionally, B vitamins should be administered to nourish the nerves and accelerate nerve repair. Moreover, adjunctive rehabilitation therapy is also crucial. For urinary incontinence, rehabilitation physicians may offer interventions such as acupuncture and training for the bladder sphincter muscle function. Most patients have a relatively good prognosis after treatment and can be cured.


What department should I go to for fecal incontinence?
If there is fecal incontinence, it is first necessary to determine the cause. If the incontinence is due to general neurological symptoms and neuropathy, then it is necessary to register for a neurology department consultation. If it is due to relaxation of the local anal sphincter, then registration with the proctology department is needed. Generally, for local sphincter relaxation causing fecal incontinence, an anal sphincter tightening procedure can be opted for, to provide local symptom relief. Additionally, it is important to also consider coordinating with traditional Chinese medicine enemas, which can enhance the mucosa within the rectum.


What should be done about postpartum urinary incontinence in women?
Generally, women are prone to urinary incontinence after childbirth. Normally, due to the significant increase in uterine pressure during childbirth, which compresses the bladder, or damage to the anterior vaginal wall, postpartum urinary incontinence can occur. If urinary incontinence is confirmed, it is still necessary to observe temporarily. Postpartum urinary incontinence can generally last three to six months, and the bladder will recover to its pre-pregnancy state. During this period, it is best to wear thicker clothes and trousers, use a pad, and maintain cleanliness of the vulva. If the symptoms of urinary incontinence cannot be alleviated, it is still necessary to perform pelvic floor exercises or undergo symptomatic surgical treatment.


Where is there a specialty for urinary incontinence?
Generally speaking, urinary incontinence falls under the category of urology, though some aspects could also be seen by specialists in men's health, who can effectively treat symptoms of urinary incontinence. Generally, it is recommended that patients seek examination and treatment in public hospitals, as the treatment provided in private hospitals is often not as reliable. For patients with urinary incontinence, it is advisable to consult the urology department if visiting a hospital. The urology department primarily deals with diseases of the kidneys, ureters, bladder, and urethra. Typically, urinary incontinence involves issues with the urethra or bladder, which can lead to incontinence. Therefore, it is advisable for patients to visit a reputable public hospital and consult the urology department.