Incontinence in women and men


Urinary incontinence

Incontinence is an awkward problems about which very little is being talked about. The main reason is a shame, but this is a problem with urination, which we do not often report to a doctor. Urinary incontinence is not a joke, a world statistics states that 15 to 50 percent of the population has some problems with it. Incontinence in women is almost two times more often than men, and the disorder is characteristic in the later years of life, due to the weakness of muscles and supporting structures of the pelvic floor responsible for proper structural integrity of the bladder. However, it is not rare in women younger age, especially after vaginal childbirth. What are the symptoms and causes of the disease and how it is treated find out in our article.

Incontinence; Symptoms

The main signs by which these unpleasant symptoms are recognized when laughing, coughing, sneezing, lifting weight, getting out of bed, running (stress urinary incontinence). The inability to hold urine when you feel the need to urinate, so-called urge incontinence, may be caused by the sound of water, hand washing, unlocking the door of the apartment or occurs without any other sign. The most common cause of urinary incontinence is the weakening of muscles and connective supporting structures of the pelvic floor - ligaments and fascia. Therefore, uncontrolled urination during pregnancy is common, but also due to difficult delivery or being overweight after surgery of the uterus and other interventions in the pelvis. The weakening of the structure occurs in the menopause, but can be a result of constitutional preferences. By uncontrolled swelling of urine there is an increase of intra-abdominal pressure, which is transmitted to the bladder. If there is a disorder of the pelvic floor support structures, which are responsible for keeping urine in the bladder, there is uncontrolled swelling of urine. This condition can be caused by neurological damage of the bladder, leading to involuntary contractions of its walls, as well as dyssynergia in the work of the bladder and sphincter (contractor) responsible for urinary retention. In men, the most common incontinence is after prostate surgery due to tumours, and rarely after surgery of benign enlargement of the gland.

URINARY INCONTINENCE; TYPES OF DISORDER

It is important to note that not all incontinences are the same: There are three basic types of incontinence:
  • Stress urinary incontinence (in 50 percent of cases) - appears as uncontrolled urination and unwanted swelling of urine in any small effort or exertion, coughing or sneezing;
  • Urge incontinence of urine (20 percent), which refers to the excessive activity of the muscles of the bladder (detrusor), which creates an increased urge to urinate (with very poor or no warning signs), and is often accompanied by unwanted urination.
  • Mixed incontinence (30 per cent) - includes symptoms of previous forms of incontinence.

Before any treatment a good diagnosis must be carried out in order to determine the exact type of incontinence. It is necessary to do a detailed analysis of blood in urine, to do the necessary urological and gynaecological examination, and often additional urodynamic testing is required. Each type has its own algorithm to incontinence treatment. In this way we avoid the use of methods (especially those involving surgery) that will help or, worse, that would only further worsen already incurred problem.

During the treatment of incontinence medications can be applied:
  1. Estrogen - stimulates proliferation of mucosa of the urethra, improves closure and enhances smooth muscle response to alpha adrenergic stimulation. These effects lead to a better closure of the urethra out of phase urination and uncontrolled urination is kept under control.
  2. Termination of alpha blockers usage which relaxes smooth muscles.
  3. The use of alpha agonists (pseudoephedrine), which directly stimulates the receptors in the bladder neck and enhances contraction.
  4. Anticholinergic (bladder relaxants): are applied when it comes to the urge for incontinence. The method of choice in the case of so-called nervous bladder, which occurs as a result of neurological damage.
  5. Botulinum toxin is injected directly into the muscle of the bladder. It is used in the treatment of neurogenic bladder, when there is no improvement after the application of anticholinergic.

URINARY INCONTINENCE; TREATMENT WITH SURGERY

Ligaments and fascial structures are crucial for the stability and normal functioning of the pelvic floor and organs which provide support. Ligaments and fascial sheaths cannot be repaired and restored, and the damage is definitive and their weight depends on the decision on the type of treatment. Conservative treatments are aimed at strengthening and increasing the mass of pelvic floor muscles, which makes up ligamentous and / or fascial weakness, while surgical treatment aims for operative access repair the resulting defects. The classic surgical method that is usually applied earlier is MMK (Marshall-Marchetti-Krantz) is used today, but much less often when it comes to urinating uncontrollably, and only in severe forms of the disorder, which are associated with Spade pelvic organs. Modern surgical therapy involves the installation tape -tot or TVT7. The procedure is simple, minimally invasive, and takes 15 to 20 minutes. It can be done under local or regional anaesthesia. Recovery is short and patients can quickly return to normal activities. Built tapes provide good support to the pelvic floor. The effects of surgery are seen immediately, the cure rate is very high. Incontinence in the elderly is often accompanied by other problems - for example disrupted anatomy of the pelvic floor (prolapse of the bladder, bowel or uterus), so it is recommended to surgically add a small net with which these defects are repaired.
Kegel exercises for incontinence

To strengthen your bladder and prevent unwanted and uncontrolled urination, do daily exercises. They are extremely important in the treatment of incontinence and are recommended in all cases of mild and moderate forms of the disease. Sometimes they lead to a complete cure, but certainly they are a good preparation for eventual surgical procedures. Recommended:
  • Kegel exercises for incontinence - strengthens the muscles of the pelvic floor. They are used in cases of diagnosed mixed and stress urinary incontinence, although it may be beneficial to those with urge incontinence. They are easy to perform, and include muscle contractions (a movement as if trying to prevent urination). They are done three times a day for a few minutes.
  • Physical therapy involves the electro stimulation of the pelvic floor. Implement by the physiatrists, and in combination with Kegel exercises often produces excellent results and uncontrollably urination in men and women is brought in line. Electrical stimulation of the pelvic floor with "Biofeed-back" is carried out using a vaginal probe, through which electroshock to the muscles and organs of the pelvis is transmitted. In this way it very successfully treats the following problems: a lighter and a medium levels of stress incontinence in women and men, urge incontinence, frequent urination during day and night, prolapse mild and medium level, preparing patients for surgical procedures in the pelvis after surgery in a small pelvis.
  • Biofeedback (bi ofeedback) is a method of treatment in which the patient is trained to control the physical processes that are normally automatic and involuntary – like urinary incontinence. All data can be measured by electrodes and displayed on a monitor in order to provide user feedback on internal processes in the body.

How normal bladder behaves?
  • It is emptied four to eight times a day, from three to four hours;
  • It contains 400-600 ml of urine, and the need to urinate occurs when there are approximately 300 ml of urine; The first sensation of the urge to urinate occurs when the bladder collected 150-200 ml of urine, but how healthy man responds to the urge to urinate it is postponed continues to be full;
  • It gives an indication that it is full, but leaves plenty of time for you to go the toilet;
  • The bladder is emptied completely after urination;
  • It does not allow uncontrolled urination and unwanted swelling of urine.
  • It can wake you up to empty it once or twice during the night, after 60 years, more than that is considered a frequent urination at night.

Prevention is a very important part in the case of all diseases, including this one. The fluid intake in the body should be moderate, because deficiency can cause urinary tract infections and too much of it can irritate the bladder. You should drink six to seven glasses of water a day. It is not advisable to take fluid two to three hours before going to bed, and it is advisable and avoiding caffeine, carbonated drinks and alcohol, which can cause irritation of the bladder. Also, it is desirable to reduce the weight and stop smoking - because it causes cough, and that increases pressure on the bladder and increases the chances that occur with uncontrolled urination. We advise you to wear cotton underwear and clothing that can be easily removed when going to the toilet. It is recommended to wear special insoles to absorb urine the so-called diaper.

How to prevent incontinence naturally

On this occasion we will mention several recipes for strengthening the bladder, to keep the uncontrolled urination in order:
  • Mix one tablespoon of lemon balm leaf, birch leaf, nettle leaf and cherry stems, pour seven ounces of boiling water and leave IT covered to rest for at least two hours. Strain and drink a cup before each major meal. Drink a total of 5 days.
  • Mix one tablespoon of leaf and milfoil flower, leaf and flower of basil, corn silk and aerial parts of the plant common couch, pour seven ounces of boiling water and leave it covered to stand for 120 minutes. Strain and drink three times a day for 2 children of this beverage, mandatory before eating. To uncontrolled urination successfully cured hold therapy for ten days.
  • Mix one tablespoon of ripe berries, leaf and flower St. John's wort and rhizomes of couch grass, and all overflow with seven decilitres of boiling water and leave it covered to stand for 120 minutes. Strain and drink three times a day a cup before meals, for a total of 10 days.
  • Mix a tablespoon of corn silk, leaf and yarrow flowers and aboveground part of the knotweed, and pour with seven decilitres of boiling water and leave aside, covered to rest for 2 hours. Strain the mixture and take 2 cups before the main meal. Drink for five days.

How to reduce frequent urination at night?
  • Mix one tablespoon of nettle leaf, leaf and flower of basil and two tablespoons of plantain leaf, and pour with seven decilitres of boiling water and leave it covered to stand for more than 120 minutes. Strain the tea mixture and drink a cup three times a day before meals. Therapy lasts for ten days.
  • Mix a tablespoon of blackberry, leaf and yarrow flower and two tablespoons of leaf and flower coin pour with 7 litres of boiling water and leave it covered to rest for 2 hours. Strain the mixture and drink a cup three times a day. Therapy lasts for 10 days.
  • Mix one large tablespoon of parsley leaf and flower of Coltsfoot and two tablespoons of sage, seven decilitres of boiling water, cover and let it rest for two hours. Drain well and consume a cup of tea before all main meals. Drink for five days.

Incontinence is a disorder that affects nearly one in seven people on our country, and it is estimated that at least 30 percent of women at some point encounter this problem, most often is incontinence after childbirth.


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