When coughing, the pressure in the abdominal cavity rises and compresses the bladder, and the bladder sphincter relaxes and urine flows out, which is the manifestation of stress urinary incontinence, and it is mostly seen in females, which can be relieved by most of the patients with appropriate treatments and rehabilitation exercises.
Stress urinary incontinence is mainly associated with aging, childbirth, pelvic organ prolapse, surgical injury and other factors.
The treatment modalities include medication, surgery, rehabilitation, lifestyle intervention, etc. The use of a single modality or a combination of modalities can improve the symptoms of urinary leakage.
1. Pharmacologic treatment:
(1) Alpha agonists: act on urethral smooth muscle α1 receptor and thus increase urethral resistance, hypertension, glaucoma patients are prohibited, long-term use is not recommended.
(2) Estrogen: for postmenopausal women, vaginal local estrogen therapy to relieve symptoms.
(2) Surgery: For patients with poor drug efficacy, severe stress urinary incontinence or combined pelvic organ prolapse requiring pelvic floor surgery, surgical treatment is available, and transvaginal mid-urethral sling surgery is the main surgical method at present.
3. Rehabilitation therapy: pelvic floor muscle function training, electrical stimulation therapy, etc., to exercise the pelvic floor muscle function and enhance the ability to control urine.
4. Lifestyle intervention: weight control, smoking cessation, reduce caffeine intake, reduce or avoid activities that increase abdominal pressure.
Warm reminder: the state of the urethral sphincter is not constant, normal people may also have a transient leakage of urine performance, if only a single occurrence, no need to be overly nervous.