In urology clinics, we often encounter some female patients who are particularly embarrassed to mention that they have uncontrollable urinary leakage when they cough hard or run and jump rope, and in serious cases, they even need to wear diapers, which obviously affects their quality of life, and because they are ashamed to talk about it, many of them are embarrassed to seek medical attention and are very distressed. We as urologists will first think that they may be the existence of stress urinary incontinence, in fact, they do not understand that incontinence is a common disease and high incidence of women, according to global statistics, the prevalence rate is close to 50% of the female population, about half of the stress urinary incontinence. A. What is stress incontinence Stress incontinence refers to the involuntary leakage of urine from the external urethra when the abdominal pressure is increased, such as sneezing, coughing or exercise. The symptoms are involuntary leakage of urine during increased abdominal pressure such as coughing, sneezing, or laughing. To put it simply, unlike normal urination, which relies on the brain to order the bladder muscles to contract and the urethral muscles to relax to allow urine to flow out, patients with stress incontinence have no desire to urinate and the bladder muscles do not contract while the urethral muscles are not actively relaxed, but the pressure in the bladder exceeds the pressure in the urethra due to external pressure on the bladder, resulting in the uncontrolled flow of urine from the urethra. Second, what factors may cause stress urinary incontinence 1, age: with age, the prevalence of female urinary incontinence gradually increased, the high incidence of age 45 to 55 years. The correlation between age and urinary incontinence may be related to the relaxation of the pelvic floor with age, estrogen reduction and degenerative changes in the urethral sphincter. Some common diseases in old age, such as chronic lung disorders and diabetes, can also promote the progression of urinary incontinence. 2, childbirth: the number of births, the age of first birth, the mode of delivery, the size of the fetus and the incidence of urinary incontinence during pregnancy are significantly associated with the occurrence of postpartum incontinence. The greater the number of births, the greater the chance of incontinence; women who deliver vaginally are more likely to have incontinence than women who deliver by cesarean; women who have a cesarean section are at greater risk of incontinence than women who have not given birth; mothers of large fetuses are also at greater risk of incontinence. 3, pelvic organ prolapse: stress urinary incontinence and uterovaginal prolapse are closely related, and the two often exist together. 4, obesity: obese women have a significantly higher chance of developing stress urinary incontinence. 5, race and genetic factors: genetic factors and stress urinary incontinence have a clear correlation. The prevalence of stress urinary incontinence is significantly correlated with the prevalence in their immediate family Other possible associated factors are smoking, constipation, intestinal dysfunction, caffeine intake and chronic cough. How to determine the degree of stress incontinence according to the symptoms: 1, mild: general activity and nocturnal incontinence, occasional incontinence when the abdominal pressure increases, no need to wear a pad. 2.Moderate: frequent urinary incontinence when abdominal pressure increases and when standing up activities, need to wear urinary pads to live. 3.Severe: urinary incontinence occurs when you get up and move around or when you change your position, which seriously affects the patient’s life and social activities. Third, how to treat stress urinary incontinence 1, pelvic floor muscle training (anal training) pelvic floor muscle training on the prevention and treatment of female stress urinary incontinence role is very positive. This method is convenient, easy to implement, effective and applicable to all types of stress incontinence. The point is that the pelvic floor muscles must be trained to a significant amount in order to be effective. Can be implemented with reference to the following method: continuous contraction of the pelvic floor muscle (lifting movement) 2 to 6 seconds, relaxation rest 2 to 6 seconds, and so on 10 to 15 times. Training 3 to 8 times a day for more than 8 weeks or longer. Some comrades may not feel good to grasp the operating principles, there is a simple trick to tell you, is to repeatedly experience the process of normal urination, conscious control of urine flow, stop urination, just remember to stop urination when the action essentials, in the usual rest contraction, relaxation interval of 5 seconds each training, 20 times each time, every day morning and evening interval open, more training, as long as you can hold on, more can be effective As long as you can stick to it, you can get results. 2, Chinese medicine treatment Traditional Chinese medicine treatment of this disease, think and spleen and kidney deficiency, mostly using the method of supplementation, warm kidney, solid astringent. I observed a large number of patients in the clinic through treatment, are tired or after the afternoon symptoms are obvious, that the disease is mostly due to the spleen and stomach Qi subsidence, the spleen and gastric gasification is not enough to affect the bladder gasification failure and the onset of the disease, so the emphasis on restoring the spleen and stomach and related organs gasification function is the key to treatment. For clinical mild to moderate patients, the following formula is recommended for use: Roasted Astragalus 30 g Radix Codonopsis 10 g Atractylodes Macrocephala 10 g Chen Pi 10 g Radix Angelicae Sinensis 10 g Sheng Ma 5 g Radix Bupleurum 5 g Raspberry 15 g Radix Platycodon grandiflorum 10 g Almond 5 g Decoction in water, one dose per day, divided into morning and evening, can be used with anal lifting training. 3.Surgical treatment After systematic examination and treatment by professional urologists, some patients may need to choose surgical treatment. At present, the commonly used clinical treatment is tension-free midurethral sling, with short-term efficacy above 90%, and the advantages are stable efficacy, less damage and fewer complications. Fourth, prevention recommendations Avoid risk factors: according to the common risk factors of urinary incontinence, take appropriate preventive measures. The possible correlation between personal habits and the occurrence of urinary incontinence should be evaluated and the exposure to susceptible factors should be reduced accordingly. 1. Weight loss is recommended: obesity is a clear correlate of stress urinary incontinence in women. Weight loss can help prevent the occurrence of stress incontinence. Obese women with stress urinary incontinence who lose 5% to 10% of their body weight will reduce the number of incontinence by more than 50%. 2, it is recommended to quit smoking: there is evidence that smoking can increase the risk of stress urinary incontinence, although there is no evidence that smoking cessation can relieve the symptoms of stress urinary incontinence. 3, pay proper attention to exercise to enhance resistance and reduce the chance of cold and cough.