In the clinic, I met a young girl who came to ask about the treatment of urinary incontinence. At first I was very puzzled because most of these patients are middle-aged and elderly women. Only after careful questioning did I understand that my attentive daughter had noticed that her mother, who was usually active, had been going out less and less for square dancing lately, and only after asking the reason did the mother embarrassingly tell her child that recently she would have urine leaking when she moved casually. This girl was very thoughtful to discover her mother’s difficulty and came to find a solution. What is urinary incontinence? In fact, urinary incontinence is a very high prevalence in the general population of middle-aged and elderly women, with an average of about one in five patients, most of whom suffer from stress urinary incontinence. The main manifestation is the involuntary flow of urine from the urethra due to increased abdominal pressure during coughing, sneezing, laughing or exercise. The occurrence of stress incontinence is associated with many factors, the more definite of which include a high number of births (and lack of proper perineal muscle training after delivery), pelvic prolapse, and obesity. Despite the high incidence, many patients take treatment lightly due to a lack of awareness of the need to seek medical attention or an inability to find the correct pathway. Many people even feel that this is a fairly common physiological condition as they get older, and that a pad will do the trick. In fact, stress urinary incontinence is a disease that is easy to occur, easy to diagnose and easy to cure! How to diagnose urinary incontinence? In terms of diagnosis, if the symptoms mentioned above are present, the diagnosis can be confirmed, but it should also be evaluated in detail by a specialist, graded, and further differentiated from other diseases. I often encounter patients who have a combination of urge incontinence, so the approach and order of management will be slightly modified. How is urinary incontinence treated? Treatment, in the case of simple female stress incontinence, there are three levels: first, pelvic floor muscle training, second, medication, and third, surgery. 1, pelvic floor muscle training Let’s start with the first point. By repeatedly and autonomously contracting the pelvic floor muscle groups to increase their toughness, endurance and responsiveness, it will improve urinary incontinence and vaginal laxity to some extent. This training is simple, easy to perform and will be effective for mild stress incontinence. The key question is how to find the right “pelvic floor muscle”. In fact, it is not difficult to try, when urinating, to make a sudden suspension of urination, is not the use of a group of muscles? That is the pelvic floor muscle, contract it on the line. Standing, sitting, lying down can be trained. Each group of 10 movements. Each contraction is held for 10 seconds. Each action interval of 10 seconds. Training 3 groups per day. Stick with it for 3 months. See if there are results? If the effect is not good, we should consider drugs or surgery. 2, drug treatment The second point is that the clinical use of drugs is not very common, one is because the effect is not very sure, and the second is because there are some side effects of drugs, such as nausea, vomiting, or cause high blood pressure. For middle-aged and elderly women, the use of these drugs should be very cautious and must be prescribed by a specialist and monitored regularly. 3. Surgical treatment The third is surgical treatment. In the past, there were many procedures, and the results were not exact, but since 1996, the invention of the non-tensile transvaginal urethral sling (TVT) to treat stress urinary incontinence can bring very good results, and brought a revolution in surgery, because minimally invasive, simple, easy to do, has become the mainstream surgical treatment of stress urinary incontinence, the operation can even be performed under local anesthesia The procedure can even be performed under local anesthesia and takes a very short time, less than 30 minutes to complete. In recent years, sling procedures have been improved, such as TVT-EXACT, TVT-O, TVT-Abbrevo, etc., resulting in fewer incisions and progressively less trauma and complications. In addition, newer procedures such as paraurethral filler injection and stem cell injection are in the process of research and development.