Urinary incontinence

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Written by Chen Tian Jing
Colorectal Surgery
1min 4sec home-news-image

What should be noted for fecal incontinence?

Patients with fecal incontinence should first pay attention to the cleanliness and hygiene of the anal area. Due to fecal incontinence, there will be fecal residue around the anus, so it is important to clean up promptly when there is fecal residue. Since feces contain certain irritating substances, these can irritate the skin around the anus, causing pain, eczema, or even provoking bedsores. Therefore, patients with fecal incontinence must frequently change positions, clean regularly, and further carry out local treatment. The most common cause of fecal incontinence is relaxation of the anal sphincter. If it is confirmed that it is due to the aforementioned reason, an anal constriction surgery can be chosen to tighten the local sphincter, thereby preventing the feces from being expelled abnormally from the anus. It could also be due to the patient being elderly and frail, with a nervous system disorder, and the primary disease needs to be actively treated.

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Written by Zhang Hui
Neurology
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What to do about urinary incontinence in dementia in the elderly?

Dementia in the elderly is a degenerative neurological disease, and there are currently no particularly effective treatments. In the later stages, it is very common for the elderly to experience urinary incontinence. This is mainly because in the later stages, the autonomic nervous system is affected. Damage to the autonomic nerves leads to dysfunction of the sphincter muscles, resulting in urinary incontinence. Currently, there are no particularly good treatments for urinary incontinence caused by dementia, but some common methods are as follows. First, it is important to kindly remind and encourage the elderly to go to the bathroom frequently, asking every one to two hours whether they feel the need to urinate, which can help avoid urinary incontinence. Second, bathrooms must have conspicuous signs that are prominently placed to help the elderly locate the restrooms easily. Third, when necessary, the elderly can be given diapers to wear to avoid embarrassment from wetting their pants. Also, it's crucial to provide psychological comfort to the elderly and avoid causing them excessive psychological burden. Additionally, other causes must be ruled out. If there is a urinary tract infection or some other urinary system disease causing the incontinence, treatment of the primary disease should be undertaken.

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Written by Zhang Hui
Neurology
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Can spinal inflammation urinary incontinence be cured?

Patients with myelitis often experience urinary incontinence because the condition affects the function of the autonomic nerves, which primarily govern the control of urination and defecation. Symptoms may include urinary incontinence, urinary frequency, or urinary retention. To treat urinary incontinence, it is first necessary to treat acute myelitis. Treatment must be timely, involving the administration of corticosteroids to suppress the inflammatory response and promote recovery from myelitis. Additionally, B vitamins should be administered to nourish the nerves and accelerate nerve repair. Moreover, adjunctive rehabilitation therapy is also crucial. For urinary incontinence, rehabilitation physicians may offer interventions such as acupuncture and training for the bladder sphincter muscle function. Most patients have a relatively good prognosis after treatment and can be cured.

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Written by Chen Tian Jing
Colorectal Surgery
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What department should I go to for fecal incontinence?

If there is fecal incontinence, it is first necessary to determine the cause. If the incontinence is due to general neurological symptoms and neuropathy, then it is necessary to register for a neurology department consultation. If it is due to relaxation of the local anal sphincter, then registration with the proctology department is needed. Generally, for local sphincter relaxation causing fecal incontinence, an anal sphincter tightening procedure can be opted for, to provide local symptom relief. Additionally, it is important to also consider coordinating with traditional Chinese medicine enemas, which can enhance the mucosa within the rectum.

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Written by Zhao Li Li
Obstetrics
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What should be done about postpartum urinary incontinence in women?

Generally, women are prone to urinary incontinence after childbirth. Normally, due to the significant increase in uterine pressure during childbirth, which compresses the bladder, or damage to the anterior vaginal wall, postpartum urinary incontinence can occur. If urinary incontinence is confirmed, it is still necessary to observe temporarily. Postpartum urinary incontinence can generally last three to six months, and the bladder will recover to its pre-pregnancy state. During this period, it is best to wear thicker clothes and trousers, use a pad, and maintain cleanliness of the vulva. If the symptoms of urinary incontinence cannot be alleviated, it is still necessary to perform pelvic floor exercises or undergo symptomatic surgical treatment.

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Written by Guan Hai Fang
Urology
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Where is there a specialty for urinary incontinence?

Generally speaking, urinary incontinence falls under the category of urology, though some aspects could also be seen by specialists in men's health, who can effectively treat symptoms of urinary incontinence. Generally, it is recommended that patients seek examination and treatment in public hospitals, as the treatment provided in private hospitals is often not as reliable. For patients with urinary incontinence, it is advisable to consult the urology department if visiting a hospital. The urology department primarily deals with diseases of the kidneys, ureters, bladder, and urethra. Typically, urinary incontinence involves issues with the urethra or bladder, which can lead to incontinence. Therefore, it is advisable for patients to visit a reputable public hospital and consult the urology department.

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Written by Chen Yu Fei
Neurosurgery
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What should I do if spinal bifida causes fecal incontinence?

When patients with spina bifida experience fecal incontinence, it generally indicates that the condition is quite severe and often requires prompt treatment. Many of these patients have an overt form of spina bifida. In such cases, a localized bulging mass can be found at the lower back, possibly accompanied by protruding spinal cord, meninges, and nerve roots. For these patients, early surgical intervention is recommended. Clinically, surgery is usually advised to remove the bulging mass and effectively separate and release the adhered nerve roots. If possible, it is best to reposition them back into the spinal canal to achieve the surgical treatment goals. Such surgeries are generally recommended to be performed at well-known, top-tier hospitals locally.

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Written by Wang Shuai
Urology
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Stress urinary incontinence clinical manifestations

The primary clinical manifestation of stress urinary incontinence is the leakage of urine from the urethra when sudden increases in intra-abdominal pressure occur, such as laughing, sneezing, or coughing. This condition is commonly seen in women who have given birth. It is mainly caused by the relaxation of the urethral sphincter and pelvic floor muscles after childbirth. The more childbirths a woman has, the higher the frequency of stress urinary incontinence. For mild symptoms, improvement can be achieved through pelvic floor muscle exercises. If necessary, medications such as Midodrine Hydrochloride tablets can be taken orally. For severe symptoms, surgery is recommended. (Medication should be used under the guidance of a doctor based on specific circumstances.)

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Written by Zhang Lu
Obstetrics
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Will urinary incontinence heal itself after a vaginal delivery?

During natural childbirth, because it can damage pelvic floor function, causing issues such as bladder prolapse, uterine prolapse, and a series of other pelvic floor dysfunctions, some women may experience urinary incontinence after giving birth. If urinary incontinence occurs after natural childbirth, it suggests that the damage to the pelvic floor functions is quite severe, and these conditions generally cannot heal on their own. First, a pelvic floor function test should be conducted to assess the condition of the pelvic floor. If the damage to the pelvic floor is minor, it can be improved through machine-assisted treatment and performing Kegel exercises, which also help enhance pelvic floor functions. If the evaluation reveals severe prolapse, pelvic floor reconstructive surgery is required to suture the prolapsed bladder or uterus back into place, which can improve urinary incontinence. Therefore, urinary incontinence after natural childbirth generally does not heal on its own.

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Written by Wang Shuai
Urology
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What are the symptoms of urinary incontinence?

Urinary incontinence mainly refers to the uncontrolled flow of urine from the urethral opening. There are several types of urinary incontinence, including stress incontinence, urge incontinence, overflow incontinence, tension incontinence, and neurogenic incontinence. Stress incontinence, commonly seen in women who have given birth, mainly refers to the leakage of urine from the urethral opening during actions that increase abdominal pressure, such as coughing, jumping rope, or sneezing. Urge incontinence is commonly seen in acute cases of bladder inflammation, where the inflammation stimulates the bladder, causing the patient to have a strong urge to urinate, thus losing control over urination, with urine flowing out from the urethral opening. Neurogenic incontinence is due to nerve damage, such as after spinal injury, leading to loss of bladder and urinary muscle function, causing urine to continuously flow out from the urethral opening.