How to treat stress urinary incontinence?

Written by Wang Shuai
Urology
Updated on November 22, 2024
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Stress urinary incontinence is commonly seen in women who have given birth, with the likelihood of occurring increasing with the number of childbirths. It primarily manifests as urine leakage through the urethral opening when there is an increase in abdominal pressure from coughing, sneezing, laughing, or lifting heavy objects. For mild urinary incontinence, improvement can be achieved through pelvic floor and urinary sphincter muscle exercises. For moderate to severe stress urinary incontinence, it is recommended to seek surgical treatment early. This can involve mid-urethral sling procedures to control urination. Post-surgery, it is also necessary to minimize situations that suddenly increase intra-abdominal pressure.

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Written by Zhou Yan
Geriatrics
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What should elderly people do if they have slight urinary incontinence?

Urinary incontinence is relatively common in the elderly. After excluding organic causes of urinary incontinence through examination, we should consider functional causes. This is mainly due to the relaxation of the urethral sphincter, pelvic floor, and the muscles around the urethra, which decreases the urethral pressure. When the abdominal pressure increases, it can cause urinary incontinence. We can improve the muscles of the pelvic floor gradually by undergoing pelvic floor rehabilitation therapy, which increases their strength and improves urinary incontinence. The key to pelvic floor rehabilitation is to provide patients with guidance and exercises for lifting the anus. By persisting in these exercises, the symptoms of urinary incontinence can be alleviated or eliminated.

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Written by Zhou Yan
Geriatrics
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What causes urinary incontinence in the elderly?

Urinary incontinence in the elderly varies due to different mechanisms and types, with the two most common categories being genuine urinary incontinence, which is due to neurogenic bladder dysfunction or overactive detrusor muscles, damage to the urethral sphincter, or loss of bladder storage function. These are commonly seen in conditions like chronic stroke, dementia, Parkinson's disease, and psychiatric diseases. The other major category is caused by relaxation of the urethral sphincter or pelvic floor muscles surrounding the urethra, leading to reduced urethral pressure. Incontinence in this category may occur when negative pressure increases, such as during coughing, sneezing, straining during bowel movements, or changing body position. This type of urinary incontinence is more common in elderly women and in elderly men who have had prostate removal, leading to damage to the external urethral sphincter.

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Written by Sun Chun
Urology
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What tests are needed for urinary incontinence?

Urinary incontinence generally requires comprehensive examinations, including the following: First, a routine urinary system examination to determine the presence of inflammation and whether it is a case of urgent urinary incontinence. Other urinary system examinations such as ultrasound can clarify whether the urinary incontinence is genuine or pseudo. A residual urine test might be conducted. For example, if a significant amount of residual urine is found after urination during an ultrasound, it may be considered pseudo urinary incontinence. Additional examinations can include urodynamics studies, which can reflect the function of the bladder detrusor muscle and the urethral sphincter. If stress urinary incontinence is confirmed, surgical treatment may be considered based on the severity of the symptoms. Stress urinary incontinence generally refers to middle-aged and older women who have had multiple natural childbirths, leading to relaxation of the pelvic floor muscles after childbirth causing relaxation of the muscles around the urethra. This can lead to urine leakage during sudden laughter, coughing, vigorous activities, or even loud speaking. In such cases, stress urinary incontinence should be considered. It is recommended to seek further diagnosis and treatment from the urology department at a local hospital.

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Written by Zhou Yan
Geriatrics
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Can elderly people with prostate enlargement experience urinary incontinence?

In the advanced stages of lower urinary tract obstructive diseases caused by prostate enlargement, overflow urinary incontinence can occur. After chronic urinary retention caused by prostate enlargement, if the bladder is extremely full, the pressure inside the bladder can exceed the resistance of the normal urethral sphincter, allowing urine to overflow through the urethra. Additionally, pressure incontinence can also be caused by damage to the external urethral sphincter or to the perineal and urethral areas following prostate surgery due to prostate enlargement.

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Written by Wang Shuai
Urology
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Should I wear diapers for urinary incontinence?

Whether patients with urinary incontinence need to use diapers should be determined based on the severity of the incontinence. If it is only mild incontinence that does not affect normal work and life, it is not necessary to wear diapers. Regular urination schedules, along with exercises like pelvic lift and pelvic floor muscle training, can alleviate the condition. However, if the incontinence is more pronounced, it is best to initially use diapers to prevent excessive urine leakage. If necessary, a urinary catheter can be used temporarily to drain the urine and prevent leakage. At the same time, it is important to actively undergo relevant examinations to determine the cause of the incontinence and carry out targeted treatment.