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Urinary incontinence
What should I do if spinal bifida causes fecal incontinence?
When patients with spina bifida experience fecal incontinence, it generally indicates that the condition is quite severe and often requires prompt treatment. Many of these patients have an overt form of spina bifida. In such cases, a localized bulging mass can be found at the lower back, possibly accompanied by protruding spinal cord, meninges, and nerve roots. For these patients, early surgical intervention is recommended. Clinically, surgery is usually advised to remove the bulging mass and effectively separate and release the adhered nerve roots. If possible, it is best to reposition them back into the spinal canal to achieve the surgical treatment goals. Such surgeries are generally recommended to be performed at well-known, top-tier hospitals locally.
Stress urinary incontinence clinical manifestations
The primary clinical manifestation of stress urinary incontinence is the leakage of urine from the urethra when sudden increases in intra-abdominal pressure occur, such as laughing, sneezing, or coughing. This condition is commonly seen in women who have given birth. It is mainly caused by the relaxation of the urethral sphincter and pelvic floor muscles after childbirth. The more childbirths a woman has, the higher the frequency of stress urinary incontinence. For mild symptoms, improvement can be achieved through pelvic floor muscle exercises. If necessary, medications such as Midodrine Hydrochloride tablets can be taken orally. For severe symptoms, surgery is recommended. (Medication should be used under the guidance of a doctor based on specific circumstances.)
Will urinary incontinence heal itself after a vaginal delivery?
During natural childbirth, because it can damage pelvic floor function, causing issues such as bladder prolapse, uterine prolapse, and a series of other pelvic floor dysfunctions, some women may experience urinary incontinence after giving birth. If urinary incontinence occurs after natural childbirth, it suggests that the damage to the pelvic floor functions is quite severe, and these conditions generally cannot heal on their own. First, a pelvic floor function test should be conducted to assess the condition of the pelvic floor. If the damage to the pelvic floor is minor, it can be improved through machine-assisted treatment and performing Kegel exercises, which also help enhance pelvic floor functions. If the evaluation reveals severe prolapse, pelvic floor reconstructive surgery is required to suture the prolapsed bladder or uterus back into place, which can improve urinary incontinence. Therefore, urinary incontinence after natural childbirth generally does not heal on its own.
What are the symptoms of urinary incontinence?
Urinary incontinence mainly refers to the uncontrolled flow of urine from the urethral opening. There are several types of urinary incontinence, including stress incontinence, urge incontinence, overflow incontinence, tension incontinence, and neurogenic incontinence. Stress incontinence, commonly seen in women who have given birth, mainly refers to the leakage of urine from the urethral opening during actions that increase abdominal pressure, such as coughing, jumping rope, or sneezing. Urge incontinence is commonly seen in acute cases of bladder inflammation, where the inflammation stimulates the bladder, causing the patient to have a strong urge to urinate, thus losing control over urination, with urine flowing out from the urethral opening. Neurogenic incontinence is due to nerve damage, such as after spinal injury, leading to loss of bladder and urinary muscle function, causing urine to continuously flow out from the urethral opening.
Does spinal bifida cause urinary incontinence during the day?
For patients with spina bifida, if it is occult spina bifida, they generally exhibit nocturnal enuresis, with rare instances of urinary incontinence during the day. For patients with manifest spina bifida, they may experience urinary incontinence during the day. Therefore, for patients with manifest spina bifida, it is usually recommended to perform surgical treatment at an early stage, with earlier surgery leading to better outcomes. It is generally advised for patients with manifest spina bifida to undergo surgery to effectively remove the locally protruding mass and to carefully clear the adherent nerve roots below, while monitoring changes in the patient's condition.
Can postpartum urinary incontinence be recovered?
Most cases of urinary incontinence postpartum in women are treatable. To manage postpartum urinary incontinence, it is essential to develop good urination habits. Patients with postpartum urinary incontinence should urinate every two to three hours. This practice can help train the bladder control muscles and enhance the new mother’s awareness of urination. Each time you urinate, try to empty the bladder completely to train the pelvic floor muscles. Regularly performing exercises that strengthen the pelvic floor muscles can increase their contraction and control abilities, alleviating cases of urinary incontinence. Most conditions can improve; however, more severe cases may require further treatment.
"What tests should be done for urinary incontinence?"
Urinary incontinence is due to damage to the bladder sphincter or nerve dysfunction, resulting in the loss of voluntary control over urination, causing involuntary leakage of urine. This condition is more common in females than males, especially in women over fifty years of age. Some routine examinations for this condition include: First, urinalysis. Second, measuring residual urine volume, cystourethrography, bladder pressure tests, and then standing cystography. Additionally, tests such as urodynamic studies are helpful.
What are the clinical manifestations of urinary incontinence?
The clinical manifestation of urinary incontinence is primarily the involuntary leakage of urine, where the patient lacks the ability to control urination. Diagnosis mainly involves reviewing the patient's medical history and a physical examination, which in most cases is sufficient to understand the type and cause of the incontinence. A urodynamic test is crucial for a definitive diagnosis. The contents of the urodynamic examination include the assessment of bladder and urethral function. If a patient exhibits the aforementioned symptoms, they should visit the urology department of a hospital for formal evaluation and treatment.
What department should I go to for fecal incontinence?
"Fecal incontinence requires registration at a colorectal surgery department for consultation. The causes of fecal incontinence mainly include neurogenic and local organic lesions of the anus. If it is due to neurogenic reasons, then it is necessary to coordinate with a neurology department to examine whether the local contraction function of the anus has deteriorated, leading to relaxation of the anal sphincter or incontinence during defecation. If there is an organic lesion in the anal sphincter, especially when the tightness of the sphincter increases leading to excessive relaxation of the anal sphincter, this can also cause fecal incontinence. To treat fecal incontinence, one can opt for local surgery to tighten the relaxed anal sphincter, thereby preventing feces from involuntarily leaking out of the anus."