Incontinence in women - causes and treatment

After a complicated labor process, the pelvic floor muscles lose their elasticity, and urinary incontinence can occur in a young woman in labor. Involuntary leakage of biofluid is also characteristic of menopause, when an aging female body undergoes a series of changes. With a weak muscular apparatus of the pelvic floor, urinary incontinence occurs with coughing, sneezing, and physical exertion. The deterioration of the tone of the urethra only aggravates the problem - the ligaments of the urethra stretch even more, provoking the further development of incontinence.

Disease classification

Doctors share urinary incontinence by signs. Classify:

1. Stress incontinence due to increased intra-abdominal pressure.
2. Urgent incontinence, in which very strong urge to urinate involuntarily occurs.

Stress, as practice shows, often becomes the main reason for the appearance of involuntary urination even with a slight filling of the bladder. A symptom of urinary incontinence is a sudden sharp urge to emit, after which involuntary leakage from the urethra occurs. To date, this type of ailment is most common among people. Urine can also be released from the urethra after increased abdominal pressure (for example, when sneezing and coughing).

Urgent incontinence appears when instability of the urinary sphincter, neurogenic dysfunction of the bladder, pathology of the mobility of the neck of the genitourinary organ, weakness of the muscles of the pelvic floor are present. As a result of various deviations, the integrity of the neuromuscular structure of the urethra and bladder is impaired. Urgent urination is characterized by hyperactivity of the walls of the bladder and contraction of the muscle walls when it is full.

Overstrain of the ligamentous apparatus of the urethra after a heavy, traumatic delivery is the main factor in the development of urinary incontinence in women.

In some women, incontinence is an integral sign of the aging of the body. The disease is very common among the female population of the planet. Changes in the organic structures of the genitourinary system develop with age. If a woman gave birth, her ligaments of the vaginal muscles, urethra and pelvic floor lose elasticity over time.

On the scale of disease severity, urinary incontinence is classified as mild, moderate, and severe. Symptoms of the disease arise due to a violation of the anatomical ratio of the organs of the female pelvis. With stress incontinence, the proximal urethra shifts. Against the background of changes in the organic structures of the urethra, the front walls of the vagina are omitted. As a result, the sphincter loses its contractility, and the muscle fibers of the apparatus are destroyed.

Development reasons

The disease is associated with the dislocation and weakening of the urethra and its ligamentous apparatus. In order for urine to hold, a certain urethral pressure is necessary. If it is violated, an involuntary leakage of biofluid develops. Indicators of urethral pressure from positive become negative. Under the influence of constant physical exertion and menopause, the disease progresses.

The main causes of the development of the disease are:

• difficult childbirth;
• pelvic surgery
• exposure to radiation;
• neurological ailments;
• anomalies and pathologies.

Factors such as overweight, taking certain medications, gastrointestinal upsets, menopause, and urinary tract infection can contribute to the progress of the disease. When collecting a medical history, the doctor pays attention to such features as the presence of hard physical work, varicose veins, somatic and anatomical pathologies.

Often, urinary incontinence in women is manifested by instillation and leakage. This is due to the weakness of the sphincter and ligamentous apparatus of the urethra. Various disorders in the ureter, vagina, urethra can affect the development of the disease.

To fix the problem, you need to seek help from an urologist andrologist. For a complete diagnosis of the disease, the doctor, after collecting a history, prescribes an urodynamic examination, cystometry and electromyography. Appropriate tests, ultrasound of the bladder, examination of the vagina and cervix are performed.

Drug therapy

For the treatment of stress urinary incontinence, drugs are prescribed that increase the tone of muscle structures. Adrenergic drugs strengthen the muscles of the pelvic floor and eliminate their weakness. Taking medications is advisable for hyperactivity of the bladder. Also in complex therapy, estrogens and antidepressants are used, which increase muscle contraction.

Medicines have a beneficial effect on the bladder tissue and increase the tone of the pelvic floor. Typically, women are prescribed the drug Driptan, but the choice of a drug to eliminate the problem depends on the characteristics of the disease and its severity. Under the influence of the prescribed drug, the structures of the bladder relax, urination to urinate is eliminated, and the number of visits to the bathroom decreases.

Driptan has a powerful antispasmodic and myotropic effect. It completely relaxes the detrusor, namely this muscle is responsible for the contraction of the bladder. As a result of drug therapy, the capacity of the cavity of the bladder increases, the number of contractions of the muscles of the pelvic floor decreases, the functions of the sphincter stabilize. It is possible to judge the results of therapy only after 1.5 months of constant medication.

In some cases, it is possible to prescribe such drugs as Trospium chloride, Tolterodin, Oxybutin. These medicines eliminate bladder hyperactivity. The treatment regimen requires proper dose selection. The drug oxybutynin has an anesthetic effect and has an antispasmodic effect. Usually, this medicine is prescribed at 2.5 to 4 mg twice a day. If there is a urinary tract infection, antibiotics are taken.

In order for the treatment to give a positive result, it must be combined with the performance of intimate gymnastics. Kegel exercises and weights help eliminate weakness in the muscles of the vagina and urethra. Such therapy has been specifically designed to stimulate the muscles of the pelvic floor.

Exercise complex

To strengthen the muscles of the perineum, Kegel exercises should be combined with a well-known gymnastic complex. It is useful to perform such poses as “birch”, “scissors”, “bicycle”. Also during the day you should wear a small ball between your legs, holding it high enough.

Women suffering from urinary incontinence require daily intimate kegel exercises. This set of exercises was designed specifically to eliminate the symptoms of incontinence. Daily pelvic floor muscle training will avoid surgery and improve the tone of the urethral ligamentous apparatus.

The complex includes such exercises for urethral structures:

• squeeze the muscles of the vagina and lift them up, hold in this position, counting to 10;
• completely relax the vagina and pelvic floor muscles, count to 10;
• repeat tension and muscle building, and after relaxation.

Alternating exercises helps increase the elasticity and tone of the urethra apparatus. The complex can be used during pregnancy and menopause, for the prevention and elimination of urinary and fecal incontinence.

Intimate gymnastics includes various squeezing and tension of the vaginal muscles. It has a very beneficial effect on the state of the urethra. To increase the tone of the pelvic floor apparatus, you can also use this exercise:

• insert the index finger into the vaginal cavity;
• squeeze finger firmly and hold pressure for about 10 seconds.

It is helpful to perform quick contractions and contractions of the vagina. Compression-expansion of the vaginal walls is carried out at least 10 times. Gradually, you can increase the time of compression and relaxation, as well as the number of approaches.

Holding weights

A good way to overcome urinary incontinence is to hold the weights with vaginal muscles. To improve the tone of the muscular system of the urethra and vagina, weights of up to 50 grams are taken. The weight should be placed in the vaginal cavity and walk around the house with it, doing the usual things. Wearing a small weight inside the vagina is required about 3-4 times during the day.

At the very beginning of such therapy, it is necessary to use loads with a minimum weight, then the weight of the products is increased. Exercise helps strengthen the muscles of the pelvic floor and stop the involuntary leakage of fluid from the urethra.

Surgical aid

With stressful and urgent forms of incontinence, surgery is indicated. The decision to conduct the operation should be after the drug therapy did not help. If treatment with drugs did not have the desired result for 3 months, then the doctor may prescribe an operation. There are a large number of different surgical techniques for eliminating urinary incontinence. Some of them are minimally invasive and quite effective.

Before the operation, the woman must undergo a full examination and prepare for surgery. The age of the patient, the characteristics of her body, the presence of chronic diseases are taken into account. The operation allows you to:

• eliminate symptoms of urgency;
• restore normal urine output;
• eliminate the anatomical displacement of the urethra and pelvic organs.

In modern medicine, the use of artificial grafts - prolene loops - has been widely developed. Such surgery is the main method of solving the problem. During the operation, the surgeon uses a curved needle, the loop is inserted under the urethra, which provides support for the canal. The doctor fixes the loop in the right position and checks its adhesion to the surrounding tissues. Next, the loop is displayed on the abdominal front wall. In another method, the loop is brought out through the groin area.

Avoid errors during surgery helps a three-dimensional image of the desired cavity on the screen. The doctor competently eliminates genital and urethral prolapse, eliminates sphincter insufficiency and corrects the anatomical location of the urethra.

The spilled product is not rejected by the female body and serves long enough to support the urethra. Gradually, the loop is overgrown with tissue, which forms an additional basis for the urethra. The operation is simple and does not require a long stay of the patient in the hospital. She leaves no scars and unpleasant marks.

After surgery, the woman is contraindicated in strong physical activity and sports. It is also necessary to abstain for a couple of months from sexual activity. Significant positive effect will give full compliance with medical prescriptions. In the recovery period, certain drug therapy can be prescribed.

Physiotherapy

Physiotherapeutic procedures help to strengthen the muscles of the pelvic floor. Hardware treatment helps stimulate the detrusor of the bladder. In the treatment of the disease are used:

• electrophoresis using antispasmodics;
• paraffin therapy;
• exposure to ultrasound;
• UV irradiation of necessary zones;
• myostimulation of muscle structures;
• SMT - therapy;
• galvanic effect.

When electrophoresis, solutions of atropine, aminophylline, platyphyllin are used. The current density is regulated using the apparatus. To resolve the problem, at least 12 procedures are assigned. After completing the full course, 20% of women experience a cessation of urine leakage during the day.

Well help to cope with the disease of applications with paraffin. They have an antispasmodic effect on the desired zones and relax the smooth muscles of the bladder. In the treatment of paraffin, heated to 45 degrees. The application is required to keep about 40 minutes. A course of paraffin therapy - at least 10 procedures.

Ultrasound treatment is a way to permanently get rid of an ailment without surgery. Under the influence of ultrasonic waves, blood supply to the pelvic floor and sphincter of the bladder improves. The muscle fibers of the urethra are stimulated, the ligamentous apparatus of the urethra is strengthened. A special apparatus helps to control and adjust the length of ultrasonic waves and their effects. To stabilize the urethra, you must undergo at least 12 procedures.

Miostimulation of the desired areas of the pelvic floor is a method that will also help to forget about the disease. Such treatment provokes a rhythmic contraction of the sphincter muscles. Therapy strengthens the muscles of the pelvic floor and urethra, and starts the necessary recovery processes in the functions of the sphincter.

There are also vegetative corrective methods of treating the disease. Galvanization of the orbital-occipital part is used, which helps to improve microcirculation of the brain, spinal cord and pelvic floor. The laser effect on the urogenital zones, as well as the use of ultraviolet irradiation of the buttocks and lower back, helps a lot. Neurogenic bladder dysfunction can be eliminated with the help of electric sleep. Applications of various muds to the groin area also contribute to strengthening and improving the tone of the muscles of the pelvic floor.

Comprehensive measures will help eliminate the problem with a competent approach. Urinary incontinence can be cured. After eliminating the problem, it is important to correct a healthy lifestyle, learn how to properly distribute physical activity. The recovery period requires some effort. It is necessary to give up alcohol and smoking, spend more time in walks in the fresh air. As a prevention of relapse of the disease, it is necessary to periodically perform gymnastics of the vaginal muscles and other exercises from the complex of physiotherapy exercises.

Video: urinary incontinence in women after 50 years