Urinary incontinence in women

Urinary incontinence in women.  Drawing from the site www.sciencephoto.com

Incontinence urine — is the involuntary leakage of urine, not giving willpower.

Why did this happen?

Urinary incontinence refers to the group of the most common diseases that adversely affects the quality of life of affected women. It is women, as different forms of incontinence most often characterized by the weaker sex among the male population of the disease is much less common. According to the European and U.S. statistics, about 45% of the female population aged 40-60 years reported symptoms of involuntary leakage of urine. According to research conducted in the territory of the Russian Federation, the symptoms Incontinence found in 38.6% of women. This is due to some peculiarities of the structure of the female reproductive system. Among the causes of urinary incontinence distinguished:

  • dysfunction of the detrusor (bladder wall muscle);
  • the failure (weakening) of the sphincters of the bladder, urethra;
  • weakening of the pelvic support structures. They are associated with pregnancy, childbirth, previous operations on the pelvic organs, the age.

What is shown?

International Society on Hold (ISC) highlights the following main forms of urinary incontinence:

  • Stress incontinence — involuntary leakage of urine during stress (change in body position, running, weight lifting, coughing, laughing, sneezing). Is urinary incontinence occurs without the urge to urination.
  • Urge incontinence incontinence (bladder syndrome imperative or overactive bladder) — involuntary leakage of urine that occurs immediately after a sudden irresistible urge to urinate. Normally, after such a urge, the patient can not stop urinating and does not have time to run to the toilet;
  • Mixed incontinence is accompanied by a sudden uncontrollable urge to urinate, combined with a certain voltage (the change in body position, running, weight lifting, coughing, laughing, sneezing);
  • Enuresis — any involuntary loss of urine at any time of the day. If involuntary urination occurs at night during sleep, then talk about nocturnal enuresis;
  • Continuous urinary incontinence — the constant dribbling of urine usually associated with insolvency sphincter system, fistula connecting uric bladder and vagina, as well as the abnormal location ureter etc.
  • Podkapyvanie, involuntary podkapyvanie immediately after normal urination. Usually associated with the accumulation of urine into the vagina or urethra diverticulum during urination.

Diagnostics

In order to correctly diagnose and prescribe competent treatment, must be a comprehensive survey of the patient, including:

  1. Medical history — this is the first phase of the survey, when a doctor needs to provide the most complete information on the number of births of their nature and duration of all surgical interventions on the pelvic organs, as well as the presence of comorbidities such as diabetes, stroke, etc.
  2. Vaginal study during which vaginal swabs taken, and the cervical canal.
  3. Ultrasound of the kidneys and bladder.
  4. Test strip is carried out to determine the amount of urine involuntarily.
  5. Urodynamic studies:
  • voiding diary;
  • uroflowmetry (assessment indicators urination);
  • cystometry (measurement of bladder pressure during filling fluid through the catheter);
  • profilometry of the urethra (the measurement of the pressure in the urethra);
  • electromyography (measuring muscle contraction of the perineum).

Treatment

Treatment for urinary incontinence depends on the identification of its forms and provide different approaches.

Currently, the treatment of stress urinary incontinence worldwide gold standard was the implementation of minimally invasive loop (sling) operations, such as TVT, TVT-O, TOT, PROLIFT. In addition to surgical intervention often used conservative treatment modalities, including special exercises for the pelvic floor (Kegel exercises), biofeedback therapy, magnetic stimulation of the neuromuscular system pelvic floor and pelvic organs, the use of a local hormone therapy in patients primenopauzalnogo age.

For the treatment of overactive bladder (OAB) is used drug therapy. Surgical treatment of such patients is contraindicated.

Patients suffering from mixed incontinence, conducted a two-stage scheme of treatment eliminated the symptoms of overactive bladder, and then performed surgery for stress urinary incontinence.

Enuresis Treatment involves the use of behavioral therapy, physical therapy, as well as medication.

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