I wonder if women have ever encountered such a situation in their lives? For example, when you cough, laugh or run and jump, there is an involuntary flow of urine, the amount is sometimes more and sometimes less, which brings inconvenience and embarrassment to your life, and in serious cases, it even leads to some people dare not laugh, dare not jump, dare not exercise, which obviously affects the normal social interaction, and becomes as if “too reserved”. …… Li Aijun, Department of Obstetrics and Gynecology, First Affiliated Hospital of Zhengzhou University In fact, “urine leakage” is a very common phenomenon among many middle-aged and elderly women. This is because there is a “valve” in each person’s body that controls urination, and in many middle-aged and elderly women, when the pelvic floor muscles are relaxed and weak, the control of the “valve” on the urethra will be weakened, and if there is a sudden increase in abdominal pressure, such as laughing, sneezing, accelerated walking, and so on. If you encounter a sudden increase in abdominal pressure, such as laughing, sneezing, accelerated walking, lifting heavy objects, you will involuntarily “leak urine”, medically known as “stress urinary incontinence”.
The main symptom of stress urinary incontinence is the involuntary flow of urine when abdominal pressure increases. It can be clinically divided into three degrees: degree I: incontinence when coughing, sneezing, lifting heavy objects and other increased abdominal pressure; degree II: incontinence when standing, walking; degree III: incontinence when standing upright or lying down. The methods of examination are as follows: finger pressure test, swab test, urine pad test, etc.; of course, the most accurate clinical examination is urodynamic examination.
Stress urinary incontinence is a common condition in middle-aged and older women, especially those who have given birth vaginally multiple times. This is because multiple pregnancies and deliveries make the pelvic floor support tissues loose, which leads to a decrease in support. However, in our country, the consultation rate is not high. The reason for this is not that the prevalence is low, but that most women consider it a natural part of aging and are embarrassed to seek medical attention because it is difficult to talk about. As a result, the condition worsens and seriously affects the quality of life.
Treatment varies depending on the severity of the disease. Non-surgical treatment can be used for milder cases with less obvious symptoms. For example: 1, improve lifestyle habits: quit smoking, reduce weight, avoid long-term standing, squatting and other work; 2, treatment of diseases that cause increased abdominal pressure: such as chronic cough, constipation, etc.; 3, insist on doing anal reduction exercises. Also known as pelvic floor muscle function exercise (Kegel exercise). The specific method is: contract the anus without force in the abdominal muscles, insist on 5 seconds and then relax, and then repeat. 15 minutes each time, 2-3 times a day. In fact, this is a very good way to enhance the pelvic floor support ability, but also very convenient and simple, there is no obvious place restrictions (the best relaxation lying in bed, but usually can). As long as the long-term persistence will definitely have an effect, but many patients in the clinic is suffering from the inability to persist, so you must build confidence!
However, for conservative treatment is not good or more serious patients, it is time to consider surgery. There are many traditional methods, but the recurrence rate is high. The best reported treatment effect internationally today is the TVT-O procedure (tension-free midurethral suspension via a closed hole). It involves placing a synthetic mesh in the middle part of the urethra, thus acting as a support when the abdominal pressure increases, to avoid downward migration of the urethra and prevent overflow of urine. I have done more of these patients in recent years and have had good follow-up results with no recurrence yet. This procedure is also very simple, with a short operative time and a quick post-operative recovery.
So, I hope my friends will stop worrying about leaking urine, and that women’s physical and mental health starts with themselves! I hope you all can live a happy and healthy life!