What is postpartum urinary incontinence?

Written by Zhang Lu
Obstetrics
Updated on December 25, 2024
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Many women experience urinary incontinence after childbirth, and the severity varies from person to person. The causes of postpartum urinary incontinence include the following aspects. First, during pregnancy, the enlargement of the uterus can significantly press on the female pelvic floor, causing damage to pelvic floor function. Second, for women who have a vaginal delivery, the fetus needs to pass through the vagina. This process can further exacerbate damage to the female pelvic floor. These factors together can lead to pelvic floor dysfunction, resulting in conditions like uterine prolapse, bladder prolapse, and even urinary incontinence. For postpartum urinary incontinence, interventions such as Kegel exercises and electrical stimulation therapy should be used together to alleviate clinical symptoms and minimize impact on daily life. If conservative treatments are ineffective, pelvic floor repair surgery should be considered.

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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 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 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 Du Rui Xia
Obstetrics
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Does postpartum urinary incontinence require surgery?

In cases of postpartum urinary incontinence, treatment should be selectively based on the individual condition of the mother. For those with mild postpartum urinary incontinence symptoms, normal recovery can be achieved through effective physical exercise and a period of rest and recuperation. However, in severe cases of urinary incontinence, surgery is also a treatment option. Therefore, the treatment for postpartum urinary incontinence should be determined based on the specific cause and severity of the condition. It is not limited to surgical treatment alone, so it is necessary to conduct an examination first and then choose the method of treatment.

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Colorectal Surgery
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Can fecal incontinence be recovered?

If fecal incontinence occurs, the first step is to identify the main cause of the fecal incontinence. If it is caused by relaxation of the anal sphincter and anal canal, then surgery can be performed to tighten this area, specifically through an anal tightening procedure, which can restore control over fecal incontinence. If the patient has other underlying diseases or is elderly and frail, accompanied by changes in the nervous system, the symptoms of fecal incontinence may be alleviated through medication or physical therapy, but complete recovery is unlikely. This is because the recovery of the nervous system requires the integrated regulation of other bodily organs and functions. If there are multiple underlying diseases or if the patient is elderly and frail, especially in the later stages of coma, recovery is difficult.