How is urinary incontinence treated?

40-year-old Ms. Du is a foreign company executives, looks both beautiful and capable, but once suffered a long time “pee pants” suffering. Beginning six years ago, she coughed, laughed, sneezed, lifting heavy objects, urine will involuntarily overflow, movement is even more powerful, and then the situation is getting more and more serious. She then dared not socialize or exercise, and was even wary of going to work. As a result, Ms. Du’s originally cheerful personality became silent and she often lost her temper for no reason. Later, accompanied by her family, Ms. Du went to the hospital and was diagnosed with stress urinary incontinence, which required surgical treatment. The doctor performed a minimally invasive surgery for Ms. Du. This new procedure is very simple and can be done under intravenous anesthesia, with the advantages of less bleeding, certainty of efficacy, low failure rate, and less damage. After the surgery, Ms. Du was free from the problem of “urine leakage” and regained her cheerful smile. Ms. Du’s case is not an isolated one. According to statistics, one out of every four women over the age of 40 in the world will experience different degrees of urinary incontinence at different stages of their lives; and in Beijing, there is almost one out of every two women over the age of 18 who suffer from urinary incontinence. The so-called urinary incontinence refers to the involuntary flow of urine out of the urethra when laughing, coughing, sneezing, or lifting heavy objects that increase abdominal pressure, and in severe cases, even when standing up or walking, urine will leak out involuntarily. Urinary incontinence in addition to physical discomfort, easy to cause urinary tract infections in addition to physical pain, but also long-term impact on the quality of life of patients, seriously affecting the mental health of patients, many patients are therefore under enormous psychological pressure, high mental tension, due to the fear of public embarrassment and shut themselves at home, as little as possible to socialize, do not want to go out of the house, self-imposed restrictions on drinking water, and no longer willing to participate in social activities and so on, to produce anxiety, embarrassment and frustration. This may lead to anxiety, embarrassment, frustration and other negative emotions, which is what people call “social cancer”. Although “social cancer” is not fatal, the inconvenience, psychological frustration and family burden caused by long-term uncontrollable urinary leakage and dribbling is no less than heart disease or other chronic diseases, and is considered one of the five major diseases affecting human health in the 1990s. Etiologically speaking, there are 2 main causes of urinary incontinence: loosening of the pelvic floor due to the destruction of pelvic floor support structures by childbirth, obesity, constipation, etc.; or atrophy of the urethral mucous membrane due to low levels of estrogen or other reasons (e.g., surgery, radiation therapy, etc.). From the source, the cause of urinary incontinence can be bladder sphincter muscle damage, can also be neurological reasons, however, many patients on the causes and treatment of urinary incontinence there is a misunderstanding of the causes of urinary incontinence, they either think that “leakage” is not a major disease is not necessary to treat, or shyness is not willing to say it, and some only as a physiological manifestation of the aging of the body! Some of them only regard it as a physical manifestation of aging, and do not know that it is also a disease. According to a survey, due to the lack of medical knowledge and the influence of traditional concepts, the tendency of female patients to seek medical treatment is very low, only less than 10% of women are willing to go to the hospital for treatment. In fact, urinary incontinence is not an unavoidable consequence of childbearing or aging; it is a disease, and a treatable one at that. With treatment, more than 90% of the patients’ symptoms can be significantly improved or even cured. Subdivided, urinary incontinence can be divided into stress incontinence, urge incontinence, mixed incontinence, filling incontinence, functional incontinence and other different categories. Although they are called “urinary incontinence”, the symptoms are very similar, but the mechanism of their occurrence is different, in the treatment method is completely different. Therefore, patients with urinary incontinence should not give themselves a random diagnosis, but still need to go to the hospital, by a professional clinician through detailed questioning, physical examination, and necessary urodynamic examination, imaging tests, etc., together, in order to make an accurate diagnosis. Stress incontinence is the most common among women. In turn, it can be categorized into three levels according to the severity of the incontinence. Doctors will choose the most appropriate, individualized treatment plan for each patient, taking into account the differences in age, weight, fertility requirements, severity of symptoms, maximum urethral closure pressure, etc. For patients with mild symptoms of urinary incontinence, they can take some therapeutic measures on their own, such as the pelvic floor muscle rehabilitation exercise method, which improves the function of the urethral sphincter by enhancing the tone of the pelvic floor muscles and urethral muscles, and increasing the muscle’s reactive contraction force in response to the pressure effect. This type of training is easy to perform, non-invasive, painless, effective and without side effects. Patients begin to see results after 3 months of adherence, and adherence for more than a year can significantly improve symptoms. For moderate and severe patients and those who do not have good results after conservative treatment, surgical treatment is recommended, as in the case of Ms. Du. With the development of science, the theory of treatment for female stress incontinence is also progressing. Original treatment theories focused on the bladder neck and proximal urethra, their dysfunction and anatomical changes. However, more modern concepts suggest that incontinence is not only related to the bladder neck, but also to the middle 1/3 of the urethra, which also acts as a “closure”. As a result, more effective surgical options have been developed. It is worth mentioning the currently popular new surgical procedure called TVT (Transvaginal Urethral Midsection Tensionless Suspension). This procedure involves making two 0.5 cm incisions in the lower abdomen or perineum and placing a synthetic suspension band through the vagina. This procedure is easy to perform, short in time, less traumatizing to the patient, and quick in recovery, and has been gradually accepted by urologists both at home and abroad, and is now the main treatment for urinary incontinence in developed countries. A more critical point is that, compared with the traditional open surgery, this new type of surgery is more effective, after more than ten years of clinical tracking reports, its effective rate of 80% to 90%. As with other diseases, the correct face, active treatment is the first condition of the patients to overcome incontinence, not because of shyness and embarrassment and silently tolerate the refusal of treatment, and do not feel sorry for themselves, frustration and chagrin, or do not take it seriously and miss the best time for treatment. In the face of incontinence, as long as early attention, early treatment can say goodbye to the annoyance of “leakage”, every day fresh, happy, and enjoy a happy and free life.