Don’t let the “leakage” bother you incontinence treatment has a good solution

  40-year-old Ms. Du is a foreign company executive, looks both beautiful and capable, but once suffered from “peeing pants” for a long time. Six years ago, she started coughing, laughing, sneezing, and lifting heavy objects, urine would involuntarily spill out, even more when exercising, and then the situation became more and more serious. She then dared not entertain or exercise, and even when she went to work, she was on edge. This caused Ms. Du’s originally cheerful personality to become 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, a new procedure that is very simple and can be done under intravenous anesthesia, with the advantages of less bleeding, positive efficacy, low failure rate and less damage. After the surgery, Ms. Du was able to get rid of the “leakage” problem and regained her cheerful smile.  Ms. Du’s case is not an isolated case. According to statistics, one out of every four women over 40 years old worldwide will have different degrees of urinary incontinence at different stages; and among women over 18 years old in Beijing, there is almost one patient with urinary incontinence for every two people. Urinary incontinence refers to the involuntary flow of urine from the urethra when laughing, coughing, sneezing, or lifting heavy objects and other actions that increase abdominal pressure, and in severe cases, even when standing up or walking, there will be involuntary leakage of urine. In addition to physical discomfort, urinary incontinence can easily lead to physical pain in addition to urinary tract infections, but also long-term impact on the quality of life of patients, seriously affecting the psychological health of patients, many patients are under great psychological pressure, high tension, because of the fear of public embarrassment and will be locked up at home, as little as possible to socialize, reluctant to go out, self-restricted drinking, no longer willing to participate in social activities, etc., and so on. This can lead to anxiety, embarrassment and depression, which is also known as “social cancer”.  Although “social cancer” is not fatal, the inconvenience, psychological frustration and family burden caused by long-term uncontrollable urine leakage and dribbling is no less than heart disease or other chronic illnesses, and is considered one of the top five diseases affecting human health in the 1990s. Etiologically speaking, there are 2 main causes of urinary incontinence: relaxation due to the destruction of the pelvic floor support structure as a result of childbirth, obesity, constipation, etc.; or atrophy of the urethral mucosa due to low estrogen levels or other causes (such as surgery, radiation therapy, etc.). However, many patients have misconceptions about the causes and treatment of urinary incontinence, they either think that “urine leakage” is not a major disease and there is no need to treat it, or they are shy and do not want to say it out loud, and some just regard it as a physical manifestation of aging. They do not know that it is also a disease. A survey shows that due to the lack of medical knowledge and the influence of traditional concepts, female patients have a very low tendency to seek medical treatment, only less than 10% of women are willing to go to the hospital. In fact, urinary incontinence is not an inevitable result of childbirth or aging, it is a disease, and a treatable disease, after treatment, more than 90% of patients can have significant improvement in symptoms, and even to cure.  Subdivided, urinary incontinence can be divided into different categories such as stress incontinence, urge incontinence, mixed incontinence, filling incontinence, functional incontinence and so on. Although they are all called “urinary incontinence”, and the symptoms are similar, but their respective mechanisms of occurrence are different, and the treatment methods are completely different. Therefore, patients with urinary incontinence should not give themselves a random diagnosis, or need to go to the hospital, by professional clinicians through a detailed examination, physical examination, and the necessary urodynamic examination, imaging, and so on, together, in order to make an accurate diagnosis. Among women, stress urinary incontinence is the most common. In turn, it can be classified into three levels according to the severity of the incontinence. Depending on age, weight, fertility requirements, severity of symptoms, maximum urethral closure pressure, etc., the doctor will take into account and choose the most appropriate and individualized treatment plan for each patient.  In the case of patients with milder symptoms of urinary incontinence, they can take some treatment measures on their own, such as 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 improving the contraction force of the muscles in response to the action of pressure. This training is easy to perform, non-invasive and painless, effective and has no side effects. Patients begin to see results after 3 months of adherence, and significant improvement in symptoms can be seen after more than a year of adherence.  In the case of 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 urinary incontinence has also been advancing. The original treatment theory focused on the bladder neck and proximal urethra, focusing on 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”. This has led to the creation of more effective surgical options. It is worth mentioning the new and popular surgical treatment, TVT, which is a tension-free suspension of the middle part of the transvaginal urethra. This procedure consists of two 0.5 cm incisions in the lower abdomen or perineum and the placement of a synthetic suspensory band through the vagina. This procedure is easy to perform, short, less traumatic for the patient and quicker to recover, and has been gradually accepted by urologists at home and abroad and is now the main treatment for urinary incontinence in developed countries. The more critical point is that, compared with the traditional open surgery, this new procedure is more effective, with an efficiency of 80% to 90% as reported by more than ten years of clinical follow-up.  As with other diseases, the correct face, active treatment is the primary condition for patients to overcome incontinence, neither shy embarrassment and silently endure the refusal to treat, nor self-hatred, frustration and chagrin, or do not take it seriously and miss the best time for treatment. In the face of urinary incontinence, as long as early attention, early treatment can say goodbye to the “leakage” of the annoyance, every day, refreshing, happy, re-enjoy a happy and free life.