Again, while laughing or coughing, you lost a few drops of urine. Millions of women around the world have such a problem. Instead of torturing yourself, tell your doctor about it. Muscle training, globules or electric stimulation are just some of the ways to solve this problem.
Contrary to popular belief, stress incontinence (SUI) affects not only older women. Almost 40 percent of them struggle with this problem. Polish women between 35 and 54 years of age. Every second patient developed symptoms before the age of 30. Although the condition is extremely troublesome, makes everyday life difficult, is associated with stress and frustration, most women are ashamed to talk about it and postpone visiting a doctor. They do not admit their problems until several years after the first symptoms appear, when they lose urine while walking.
Guilty Weak Muscles
SUI is a symptom of abnormal functioning of the bladder, urethra and sphincter due to the weakening of the pelvic floor and urogenital diaphragm muscles (the layer of muscles at the bottom of the torso that keeps the internal organs in the right position). The relaxation of these muscles changes the correct position of the bladder and urethra, which disrupts their functioning. The lowered bladder creates an obtuse rather than acute angle with the urethra, preventing the sphincter from tightly closing. Then, when sneezing, bending down, picking up shopping, climbing stairs or having sexual intercourse, and in extreme cases also while walking, they “let go of the valves”. Sometimes warning signals appear earlier, e.g. frequent small amounts of urine, pressure on the bladder, feeling of a full bladder right after leaving the toilet. However, often the first symptom of the disease is letting go. This is a huge problem because the woman feels that she is losing her urine and is unable to control it. The disease often affects young mums as a result of stretching or damage to the muscles and ligaments during childbirth. Usually women ignore the ailment, hoping that it will go away on its own. And this only makes subsequent treatment difficult.
SUI often occurs in women during menopause - then the decrease in the level of sex hormones is responsible for letting it down, which has a huge impact on the state of muscle tone. Hormonal changes in a woman's body during this period lead to a deterioration of the blood supply and contractility of muscles and ligaments. The reproductive organ declines,the uterus and the coil contract, so it starts to drain like a faucet with a broken seal. The disease affects obese women who work hard physically, engage in competitive sports and lead a sedentary lifestyle. It is favored by chronic urinary tract infections, diabetes and constipation. SUI can be a consequence of gynecological and urological operations as well as neurological diseases.
Not only urine analysis
In case of disturbing symptoms, immediately consult a gynecologist or urologist (a referral to a urologist is required). The specialist will want to know the symptoms in detail, ask about childbirths, operations, and general he alth. The basic examination is a general urinalysis. If bacteria are found in the bladder, you will need to have a urine culture test and treat the infection (urinary tract infection exacerbates the symptoms of SUI). The doctor may recommend an abdominal ultrasound to assess the residual urine in the bladder after emptying it, but the most important thing is a functional test of the urinary tract, the so-called urodynamic. With the help of a catheter, the bladder is filled with distilled water, and then its work is recorded: the pressure is measured, the work of the sphincter is assessed, and the amount and speed of water flowing out during emptying. The work of muscles in the vagina and rectum is checked. The length of the urethra and its pressure can be measured.
From exercise to surgery
The method of treatment depends on the cause and the degree of ailment, defined on a scale from 0 to III. The methods are selected individually, combining therapies and modifying them as he alth improves.
Muscle training.The less advanced the disease (stage I, II), the better the results are provided by exercises to strengthen the pelvic floor muscles. Your doctor or physiotherapist will teach you how to do them. If you regularly exercise many times a day (15-30 minutes a day), they will help to get the problem under control. After you feel better (after about 6 months), keep exercising to keep your muscles in good shape. The exercises consist of tightening the so-called the Kegel muscles between the pubic and coccyx bones that keep the bladder in place and allow it to function properly. You can practice everywhere, e.g. at work, on the tram, standing in a traffic jam, even in the toilet.
- While standing, try to tighten your buttocks tightly as if you want to keep a sheet of paper between them.
- While sitting, tighten the muscles around the anus.
- In the toilet, pause the stream of urine for a few seconds, clenching your muscles.
Another training is to insert a special weight into the vagina. You have to flex your muscles for half an hour so that it does not fall out. If it fails,it is replaced with a bigger one. The exercises are repeated until the problem disappears. Your doctor may recommend inserting a vaginal disc (you can buy it at a pharmacy), which, by lifting the vagina and bladder, facilitates controlled urination.
Globules, tablets.If the problem is not big and results from a disturbed hormonal balance, the doctor may prescribe hormonal preparations in the form of globules or tablets. Balancing the level of estrogens in the blood improves the condition of the muscles and mucosa of the urethra, making it more elastic and tight, which helps to overcome ailments. In perimenopausal women, stress urinary incontinence is often associated with overactive bladder (it can also occur spontaneously). The bladder becomes oversensitive due to nervousness or neurological conditions, such as spinal discopathy. Even a small amount of urine reacts with a sudden urge, causing it to leak out uncontrollably. Drugs that reduce bladder spasms (anticholinergics) help. Unfortunately, they are expensive (the cost of a monthly treatment is about PLN 100), and you have to take them constantly. In addition, they cause the mucous membranes to dry out, especially in the mouth, which is troublesome. To reduce costs, after several months of treatment, doctors sometimes suggest stopping the drug until the disease recurs. Then you have to take the pills again and you will take a break again.
Stimulation with electricity.The treatments involve stimulating certain structures of the body with electricity, which cause contraction and training of the muscles of the perineum. It is also possible to stimulate certain nerve fibers with current. Depending on the method, the procedure is performed using a vaginal electrode or external electrodes. You can buy electrostimulators powered by batteries. However, due to the contraindications, the treatments must not be used without consulting a doctor. The action of the magnetic field is also used in the treatment of SUI. Pulsating fields cause alternating contractions and relaxation of the pelvic floor muscles, stimulating them to work.
Operation.Restores the correct position of the reproductive organ, bladder and urethra. It is up to the doctor to choose a method. The older one, an abdominal operation, involves lining the coil. Today, the most commonly used technique is less invasive, involving the suspension of a polypropylene tape under the coil, which supports the coil during exercise and prevents urine from passing. The procedure is performed through the vagina under lumbar anesthesia. It takes about 30 minutes, you come for surgery in the morning, and you can go home in the evening. Lifting, bathing and intercourse must be avoided for several weeks. Over 90 percent of women completely recover.
monthly "Zdrowie"