Prevention and treatment of stress urinary incontinence

  Currently, the treatment of moderate to severe urinary incontinence is based on surgical treatment, supplemented by medication and training therapy. Surgical treatment can completely cure urinary incontinence, while non-surgical treatment can only improve the symptoms of incontinence and cannot achieve a curative effect, therefore, non-surgical treatment is often used as an adjunct to consolidate the effectiveness of surgery.  Training treatment 1, pelvic floor muscle training: tighten the anus for more than 3 seconds, and then relax. Do it continuously for 15-30 minutes, 2-3 times a day. Or 150-200 times a day, 6-8 weeks for a course of treatment. The purpose is to enhance the support of the pelvic floor muscle groups and reset the backward or prolapsed bladder, thus restoring the normal angle between the bladder and urethra. At the same time, exercise is strengthened to enhance physical fitness. Diseases related to increased abdominal pressure, such as constipation and chronic cough, should also be treated promptly.  2. Vaginal ball: The patient uses a vaginal ball to exercise the pelvic floor muscles. The vaginal ball is a weighted device placed in the vagina and the patient has to work hard to contract the pelvic floor muscles to maintain the ball in a certain position. The contraction should be maintained for 15 minutes. This exercise is performed twice daily and will improve symptoms in about 70% of women after 4-6 weeks.  3. Electrical stimulation: The pelvic floor muscles are stimulated with a low-voltage electric current that is conducted through anal or vaginal electrodes to cause the corresponding muscle groups to contract. Electrostimulation can be done in the hospital or at home. The treatment usually lasts 20 minutes and is repeated once every 1-4 days. Vaginal rests or urethral clamps: can support the bladder and urethra exactly or help in the closure of the urethra.  Medications 1. Adrenergic agonists: The most commonly used medication for stress incontinence, these medications treat stress incontinence by increasing the ability of the urethral sphincter to close.  2, anticholinergic drugs: some cases can be treated with anticholinergic drugs, such as: promethazine bromide, promethazine, hydroxybutynin hydrochloride.  3, estrogen: estrogen can be used to treat postmenopausal women with stress urinary incontinence. Estrogen has the effect of increasing the tone and blood supply of the urethral sphincter. There are oral estrogen tablets and creams for transvaginal administration, but the efficacy is controversial. In addition, patients with stress urinary incontinence who have breast cancer, cervical cancer, or uterine cancer should not receive estrogen medication.  4.Chinese herbal medicine treatment: Some Chinese herbal medicines that enhance the body’s resistance and immunity and replenish blood and qi also have certain curative effects. For example: Tonic Chinese and Qi Pills, Ten Perfect Tonic Soup, etc.  Surgical treatment Surgical treatment methods include: posterior urethral injection sclerotherapy, various suspensions, artificial urethral sphincter placement and urethral lengthening or folding surgery. Our hospital carried out this kind of surgery earlier in China, and adopted the surgical treatment of suspension of urethra and bladder since 2000. This method addresses the factors of bladder bulge and unstable bladder at the same time. The postoperative results are very satisfactory.