Urinary incontinence is a relatively common condition in middle-aged and elderly women. Clinically there are three main types of incontinence: urge incontinence, stress incontinence and overflow incontinence. Urgency incontinence manifested as a sense of urine when it is too late to go to the toilet urine leakage, sometimes open the water pipe and other conditioned reflex urine will flow out; pressure incontinence manifested as coughing, jumping, stairs, lifting heavy objects and other abdominal exertion of any action, there will be a leakage of urine, and even smile, sneeze urine will flow out; overflow incontinence is mainly due to a variety of reasons for urinary difficulties caused by the bladder in the urine After the bladder is full, the pressure in the bladder and the resistance of the urethra to reach a balance, the urine slowly seeps out along the urethra, usually occurs in the bladder contraction weakness of neurogenic bladder patients, such as diabetes mellitus and post-stroke patients. Clinical common incontinence in middle-aged and elderly women is mostly stress incontinence. Although urinary incontinence is not a major disease, but it seriously affects the quality of life of patients such as daily life and social activities, many patients do not dare to participate in social activities. “Urinary incontinence brings physical pain and psychological pressure to many middle-aged and elderly women. However, due to the lack of awareness of this disease, only 10-20% of the patients really go to the hospital for treatment, and a considerable part of the patients do not get timely and effective treatment. Some think that people may be so old, not as a disease; some are afraid of jokes, it is difficult to speak; some want to see the hospital do not know to see that section, coupled with the poor results of previous surgical treatments, so that many patients live in the long-term pain of the disease. Urinary incontinence etiology is complex The main pathological changes of stress incontinence is endogenous urethral sphincter weakness and bladder urethra posterior angle of excessive downward movement of the two, the latter is more common, a few patients with both. According to the relationship between storage and voiding, normal human physiology can only be accomplished if the bladder detrusor and urethral sphincter are complementary and closely synergistic. Problems with either of the two sets of muscles can result in dysuria. Women are more prone to urinary incontinence than men for many common reasons: 1, women are born with a shorter urinary tract and are prone to urinary tract infections; 2, loose pelvic muscle ligaments after pregnancy and childbirth, poor rest after childbirth and premature weight bearing; 3, having more children or poor repair of birth injuries, resulting in pelvic floor musculofascial defects; 4, after menopause, the function of the ovaries to synthesize estrogen is greatly reduced, and the urethra and bladder After menopause, the function of the ovaries to synthesize estrogen decreases greatly, the urethra and bladder mucosa shrinks and the wrinkled wall disappears, resulting in the weakening of the closed urethra. Due to the disease to remove both sides of the ovaries of young women, but also because of the low level of estrogen caused by stress urinary incontinence; 5, pelvic surgery on the bladder and urethral tissues directly or indirectly after the injury and so on. Urinary incontinence focuses on prevention 1, to have optimistic, open-minded mood. With a positive and calm state of mind, laugh at the successes, failures, pressures and troubles in life and work, and learn to regulate their own state of mind and emotions. 2, to prevent urinary tract infection. Usually develop the habit of wiping the handkerchief from front to back after urination and defecation, to avoid urethral infection; before sex, couples wash the vulva with warm boiled water, immediately after intercourse, the female party to empty the urine, wash the vulva; if urinary pain, urinary frequency after sexual intercourse, oral anti-urinary tract infection drugs for 3-5 days, in the early stage of inflammation and rapid cure. 3, maintain a regular sex life. Research has proved that menopausal post-menopausal women continue to maintain a regular sex life, can significantly delay the physiological degeneration of the ovarian synthesis of estrogen function, reduce the incidence of stress urinary incontinence, and at the same time, can prevent other geriatric diseases, improve the level of health. 4, strengthen physical exercise, active treatment of various chronic diseases. Such as emphysema, asthma, bronchitis, obesity, huge tumors in the abdominal cavity, etc., can cause increased abdominal pressure and lead to urinary incontinence, and these chronic diseases should be actively treated to improve the nutritional status of the whole body. At the same time, appropriate physical exercise and pelvic floor muscle group exercise should be carried out. The easiest way is to get out of bed every morning before and at night after going to bed lying down, each do 50-100 times to tighten the anus and lift the anus activities, can significantly improve the symptoms of urinary incontinence. 5, women should pay attention to rest after giving birth to a child. Maternity should not be too early weight bearing and exertion, every day should adhere to the contraction of the anus 5-10 minutes. Pay attention to weight loss, if there is a birth injury should be repaired in time. 6, pay attention to the diet light. Eat more fiber-rich food to prevent the increase of abdominal pressure caused by constipation. 7, early detection, early treatment. If you find that there is a feeling of vaginal blockage, a lump protruding from the vulva when you urinate or defecate or exert yourself, vaginal secretions with a bad smell or blood, difficulty in urination, not smooth, frequent urination or incontinence, lumbar pain and other symptoms, you should consult a doctor in time, to prevent the pelvic organs from prolapsing. Urinary incontinence can be cured Urinary incontinence is not an incurable disease, as long as early detection, early treatment, completely curable. Clinical incontinence can be divided into mild, moderate, severe three phases, according to the different degrees of the condition, can be taken conservative treatment and surgical treatment. Conservative treatment 1.Estrogen replacement therapy In recent years, experts from all over the world actively advocate the application of estrogen replacement therapy to supplement the estrogen deficiency in menopausal women to prevent and control senile vaginitis, stress urinary incontinence, coronary heart disease, osteoporosis, etc., and have obtained significant results. Some menopausal older women may experience a small amount of “menstruation” at the beginning of estrogen replacement therapy, which is normal and can continue to be applied, and will gradually disappear later. Due to individual differences in sensitivity to estrogen, the use of estrogen replacement therapy should be individualized under the guidance of experienced specialists. People who have suffered from endometrial cancer, breast cancer, cervical cancer, ovarian cancer should not use the drug or use it with caution. In addition, the flattening or disappearance of the folded walls of the urethral mucosa results in a decrease in immunity against upstream infection by pathogenic microorganisms. Therefore, patients with stress urinary incontinence have a high rate of urinary tract infection, estrogen replacement therapy and anti-infection should be carried out at the same time in order to obtain satisfactory results in a short period of time. 2. Exercise therapy Some scholars statistically analyze that about 70% of patients with stress urinary incontinence can be reduced or corrected by strengthening the pelvic floor muscle tone exercise. The methods are: (1) 50-100 times a day to tighten the anus and vagina movement, 3-5 seconds each time; (2) lying on the bed, at least 2 times a day for sit-ups, 10 minutes each time; (3) lying on the bed to carry out fast and regular stretching of the legs movement, 3 times a day, 10 minutes each time; (4) the promotion of squatting bowel movement. Squatting is good for maintaining or improving pelvic floor muscle tone. 3. Acupuncture and moxibustion Acupuncture at Zhongji, Guanyuan, Ashigaru, Sanyinjiao and other points can also improve the tone of the pelvic floor muscles, thus improving bladder function. Surgery Conservative treatment is suitable for patients with mild urinary incontinence. For patients with moderate or severe urinary incontinence, it is difficult to achieve the desired effect with simple conservative treatment, and surgical treatment must be adopted. Traditional surgical methods generally take the anterior vaginal wall repair, the long-term effect is poor, and is limited to patients with mild urinary incontinence. The tension-free “urethral suspension” and “bladder neck suspension” using polypropylene mesh tape have achieved good results in the treatment of female stress urinary incontinence, and are currently the simplest, most effective and long-lasting treatment methods. It is the easiest and most effective treatment with the longest lasting effect. The method is to suspend the bladder neck through minimally invasive surgery using a very biocompatible suspension belt. After surgery, the fibrous tissue in the patient’s body will gradually grow into the polypropylene mesh belt, so it can effectively keep the urethra supported for a long time, and some people call this kind of sling “flexible stent”. Suspension surgery for female urinary incontinence is characterized by no open abdomen, little surgical damage, short time, can be completed under local anesthesia. The patient has little pain, quick recovery, good postoperative urinary control, and it is not easy to recur. It is very suitable for elderly women, especially those who suffer from internal diseases and are not easy to tolerate open abdominal surgery, and has been commonly used in developed countries in Europe and the United States.