Incontinence of urine in women has a negative effect on almost all aspects of life, significantly complicating professional activities, limiting social contacts and introducing disharmony in family relationships.
This problem is considered by several branches of medicine - urology, gynecology and neurology. This is due to the fact that urinary incontinence is not an independent disease, but only a manifestation of various pathologies in a woman’s body.
It is a mistake to assume that urinary incontinence affects, if not the older part of the fair sex, then women after 50 years. The disease can occur at any age. Especially if the lady overstepped the mark in thirty years, or gave birth to 2-3 babies. The problem does not carry a danger to the female body, however, it suppresses morally, greatly reduces the quality of life of the patient.
In this article we will look at why urinary incontinence occurs in women, including those over 50 years old. What causes this phenomenon, and what to do with it at home.
There are several types of urinary incontinence in women, namely:
- Imperative. Female urinary incontinence can be the result of malfunctioning of the central and peripheral nervous systems, as well as violations of the innervation of the bladder itself. In this case, the woman is worried about the extremely strong urge to urinate, sometimes it is impossible to resist urine by force of will. In addition, the patient may suffer from frequent urination during the day (more often 8 times) and at night (more often 1 time). This type of disturbance is called imperative and is observed in case of hyperactive bladder syndrome.
- Stress urinary incontinence in women is associated with sudden increases in intra-abdominal pressure resulting from lifting heavy objects, coughing or laughing. Most often, physicians have to deal with stress urinary incontinence in women. Muscle weakening and pelvic organ prolapse are also associated by specialists with the amount of collagen found in menopausal women. According to medical statistics, 40% of women have experienced stress urinary incontinence at least once in their lives.
- Mixed form - in some cases, a combination of imperative and stressful incontinence is possible in women. This phenomenon is most often observed after childbirth, when traumatic damage to the muscles and tissues of the pelvic organs leads to involuntary urination. This form of urinary incontinence is characterized by a combination of an irresistible desire to urinate with uncontrolled leakage of fluid under stress. Such a violation of urination in women requires a bilateral approach to treatment.
- Enuresis - a form characterized by involuntary release of urine at any time of the day. When nocturnal incontinence is noted in women, it is a matter of nocturnal enuresis.
- Urge incontinence is also characterized by involuntary urination, which, however, is preceded by a sudden and overwhelming urge to urinate. When there is a similar urge, the woman is unable to stop urination, she does not even have time to reach the toilet.
- Permanent incontinence is associated with pathology of the urinary tract, anomalous structure of the ureter, failure of the sphincter, etc.
- Undermining - immediately after urination, a slight undermining of urine occurs, which remains and accumulates in the urethra.
The most common are stress and urge incontinence, all other forms are rare.
Causes of urinary incontinence in women
In the female part of the population, including after 50 years, the reasons for the appearance of urinary incontinence can be very diverse. However, this pathology is most often observed in those women who gave birth. In this case, a large percentage of cases are seen among those who have had protracted or rapid delivery, if they were accompanied by pelvic floor breaks or other birth injuries.
In general, urinary incontinence occurs due to weakening of the pelvic floor muscles and / or small pelvis, impaired functioning of the urethral sphincter. These problems can be provoked by the following diseases and conditions:
- childbearing and childbirth;
- overweight, obesity;
- advanced age (after 70 years);
- bladder stones;
- abnormal structure of the urogenital system;
- chronic bladder infections;
- chronic cough;
- Alzheimer's, Parkinson's;
- cancer of the bladder;
- prolapse of the pelvic organs;
- chronic cough.
Also, increased manifestations of urinary incontinence at any age, and some drugs, as well as food: smoking, alcoholic beverages, soda, tea, coffee, drugs that relax the bladder (antidepressants and anticholinergics) or enhance urine production (diuretics).
To understand how to treat urinary incontinence in women, it is necessary not only to diagnose a symptom, but also to determine the cause of its development. Especially when it comes to women after 50 or 70 years.
Therefore, for the correct choice of treatment tactics (and to avoid mistakes), it is imperative that the following special examination protocol be carried out:
- filling in specific questionnaires (the best option is ICIQ-SF, UDI-6),
- urination diary compilation,
- daily or hourly test with gaskets (pad test),
- vaginal coughing examination,
- Ultrasound of the pelvic organs and kidneys,
- complex urodynamic study (KUDI).
Female urinary incontinence treatment
The most effective treatment depends on the cause of urinary incontinence in a woman, and even your personal preferences. Therapy is different for each woman and depends on the type of incontinence and how it affects life. After the doctor diagnoses the cause, treatment may include exercise, bladder control training, medication, or a combination of these methods. Some women may need surgery.
General recommendations for controlling urination:
- a caffeine-free diet (without coffee, strong tea, cola, energy drinks, chocolate);
- control body weight, fight obesity;
- non-smoking, alcoholic beverages;
- emptying the bladder by the hour.
Conservative methods of treatment are indicated mainly to young women with unexpressed incontinence occurring after childbirth, as well as in patients with an increased risk of surgical treatment, in elderly patients who have previously been operated on without a positive effect. Urge incontinence is treated only conservatively. Conservative therapy usually begins with special exercises aimed at strengthening the muscles of the pelvic floor. They also have a stimulating effect on the abdominal muscles and pelvic organs.
Depending on the cause of enuresis in women, various drugs, tablets are prescribed:
- Sympathomimetics - Ephedrine - helps to reduce the muscles involved in urination. The result - enuresis stops.
- Anticholinergics - Oxybutin, Driptan, Tolteradin. They provide an opportunity to relax the bladder, as well as increase its volume. These medicines for incontinence in women are prescribed to restore control of the urge.
- Desmopressin - reduces the amount of urine formed - is discharged with temporary incontinence.
- Antidepressants - Duloxitin, Imipramine - are prescribed if stress is the cause of incontinence.
- Estrogens - drugs in the form of female hormones progestin or estrogen - are prescribed if incontinence arises due to a lack of female hormones. This happens during menopause.
Incontinence in women can be managed with medication. But in many cases, treatment is based on a change in behavioral factors and therefore Kegel exercises are often prescribed. These procedures in combination with medications can help many women with urinary incontinence.
Kegel exercises can help with any type of urinary incontinence in women. These exercises help to strengthen the muscles of the abdominal cavity and pelvis. When performing exercises, patients should strain pelvic muscles three times a day for three seconds. The effectiveness of the use of a pessary, special intravaginal rubber devices largely depends on the type of incontinence and the individual characteristics of the anatomical structure of the body.
Squeeze the muscles of the perineum and hold the squeeze for 3 seconds, then relax them for the same time. Gradually increase the duration of compression-relaxation to 20 seconds. At the same time, relax gradually. Also use the quick contraction and activation of the muscles used in stool and childbirth.
If devices and drugs for incontinence in women do not help, then there is a need for surgical treatment. There are several types of surgery that can help resolve this problem:
- Sling operations (TVT and TVT-O). These minimally invasive interventions, lasting about 30 minutes, are performed under local anesthesia. The essence of the operation is extremely simple: the introduction of a special synthetic mesh in the form of a loop under the bladder neck or urethra. This loop keeps the urethra in a physiological position, not allowing urine to flow with an increase in intra-abdominal pressure.
- Burch laparoscopic colposuspension. The operation is performed under general anesthesia, often laparoscopic access. Tissues located around the urethra, as if suspended from the inguinal ligaments. These ligaments are very strong, so the long-term results of the operation are very convincing.
- Injection volume preparations. During the procedure, a special substance is injected into the submucosal membrane of the urethra under the control of a cystoscope. More often it is a synthetic material that does not cause allergies. As a result, the missing soft tissues are compensated and the urethra is fixed in the desired position.
Any incontinence surgery is aimed at restoring the correct position of the organs of the urinary system. An incontinence surgery causes urine leakage when coughing, laughing and sneezing occurs much less frequently. The decision to perform surgery for incontinence in women should be based on the correct diagnosis, since the absence of this aspect can lead to serious problems.
Folk treatment of urinary incontinence in women
Opponents of traditional methods of treatment are probably interested in the question of how to treat urinary incontinence with folk remedies. In this aspect, there are several recipes:
- Perfectly help the seeds of dill garden. 1 tablespoon of seeds is poured with a glass of boiling water and left for 2-3 hours, well wrapped. Then the resulting infusion filter. All the glass means you need to drink for 1 time. And so do every day to get the result. Folk healers claim that urine incontinence can be cured in this way in people of any age. There are cases of complete recovery.
- Sage herb infusion: one cup should be consumed three times a day.
- Steamed infusion of yarrow herb should be drunk at least half a glass 3 times a day.
- Yarrow is a grass that is found almost everywhere - a real storehouse for traditional healers. If you need to get rid of involuntary urination, then take 10 grams of yarrow with flowers in 1 cup of water. Boil 10 minutes on low heat. Then leave to insist for 1 hour, do not forget to wrap your decoction. Take half a cup 3 times a day.
In the treatment of folk remedies, it is important not to start the process of urinary incontinence and to prevent the development of more serious diseases, which may be caused by involuntary urination (for example, cystitis, pyelonephritis).