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Urinating without knowing: What Is Urinary Incontinence? Symptoms, Causes, Diagnosis, Treatment, and Prevention

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What Is Urinary Incontinence? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Urinary incontinence is easy to recognize. The primary symptom most people experience is an involuntary release of urine. But the type and cause of the incontinence can be more difficult to determine and may require a variety of exams and tests. Most physicians will use the following: (9)

A bladder diary Your doctor may have you track your fluid intake and output over several days. This may include any episodes of incontinence or urgency issues. To help you measure the amount of urine you pass during an episode of incontinence, you may be asked to use a calibrated container that fits over your toilet to collect the urine.

Urinalysis A urine sample can be checked for infections, traces of blood, or other abnormalities, such as the presence of cancer cells. A urine culture can assess for infection; urine cytology looks for cancer cells.

Blood tests Blood tests can look for chemicals and substances that may relate to conditions causing the incontinence.

Pelvic ultrasound In this imaging test, an ultrasound device is used to create an image of the bladder or other parts of the urinary tract to check for problems.

Postvoid residual (PVR) measurement In this procedure, the patient empties the bladder completely and the physician uses a device to measure how much urine, if any, remains in the bladder. A large amount of residual urine in the bladder suggests overflow incontinence.

Stress test In this test, the patient is asked to cough or vigorously tense her midsection as though exerting herself while the physician checks for loss of urine.

Urodynamic testing This test measures the pressure that the bladder muscles and urinary sphincter can tolerate both at rest and during filling.

Cystogram In this series of X-rays of the bladder, a dye is injected into the bladder and as the patient urinates, the dye shows up in the X-rays and can reveal abnormalities in the urinary tract.

Cystoscopy This procedure uses a thin tube with a tiny lens and a light at one end called a cystoscope. After the administration of some sedation medications or anesthesia, the cystoscope is inserted into the urethra and the physician visually checks the lining of the bladder and urethra.

RELATED: How Doctors Diagnose Kidney Stones and What to Know Before Your Appointment

Prognosis of Urinary Incontinence

UI is usually curable, and if not, then controllable. (5)

Leakage, Causes, Diagnosis, Treatment & Prevention

Overview

What is incontinence?

Urinary incontinence is a condition that impacts many people’s lives. When you have incontinence, you may experience bladder control issues and leak urine. This leakage is often uncontrollable and can negatively impact your life.

Your urinary system is made up of the kidneys, ureters, bladder and urethra. These parts do several jobs. They filter, store and remove waste from your body. Your kidneys are the filters of your body. Waste products are removed from your blood by the kidneys, creating urine. The urine then moves down through two thin tubes called the ureters. The ureters connect to the bladder, where the urine will collect until it’s time to leave the body. Your bladder is like a storage tank — once the bladder is full, the brain sends a signal that it’s time to urinate. Urine then leaves the bladder when a muscle opens up (sphincter), allowing the urine to flow freely out of the body through the urethra.

When this system is working smoothly, you usually have time to get to a bathroom before needing to urinate and you don’t experience any leakage of urine. Urinary incontinence can happen when these parts don’t operate as they should. This can happen for many different reasons throughout your life.

Many people think that incontinence is a normal part of aging that can’t be helped. While it is true that your risk of incontinence increases as you get older, there are also treatments available to help you manage this condition. Incontinence doesn’t have to disrupt your life and keep you from being active.

What are the different types of incontinence?

There are several different types of incontinence. These types have different causes, characteristics and triggers for urine leakage. Knowing the type of incontinence is often an important part of the diagnosis and treatment plan for incontinence.

The types of incontinence include:

  • Urge incontinence: This type of incontinence is characterized by an intense need to urinate right away. Often, this happens too quickly for you to make it to a toilet and you end up leaking urine. Urge incontinence can be caused by a condition called overactive bladder (OAB). You could have OAB for a variety of reasons like having weak pelvic muscles, nerve damage, an infection, low levels of estrogen after menopause or a heavier body weight. Some medications and beverages like alcohol and caffeine can also cause OAB.
  • Stress incontinence: When you leak urine during activities, this is often stress incontinence. In this type of incontinence, your pelvic floor muscles are weak and no longer support your pelvic organs as they should. This muscle weakness means that you’re more likely to accidently leak urine when you move around. For many people, leakage issues happen when they laugh, cough, sneeze, run, jump or lift things. These actions all place pressure on your bladder. Without the support of strong pelvic muscles, you’re more likely to leak urine. Women who have given birth are at a higher risk of having stress incontinence. Men who have had prostate surgery may develop stress incontinence.
  • Overflow incontinence: If your bladder doesn’t empty completely each time you urinate, you could have overflow incontinence. Think of the bladder as a juice jug. If you only pour some of the juice out of the jug, but not all of it, there’s still a risk that you could spill when you move around. People with overflow incontinence never completely empty the bladder — placing them at risk for a spill. Usually, this results in small amounts of urine dripping out over time instead of one big gush of urine. This type of incontinence is more common in people with chronic conditions like multiple sclerosis (MS), stroke or diabetes. This may also occur in men with a large prostate.
  • Mixed incontinence: This type of incontinence is a combination of several problems that all lead to leakage issues. When you have mixed incontinence, you might be dealing with stress incontinence and an overactive bladder. It’s often important to pay attention to what you’re doing when you have leakage issues with this type of incontinence. Identifying what triggers mixed incontinence is usually the best way to manage it.

Who gets incontinence?

Incontinence can happen to anyone. However, it’s more common in certain groups and at certain times in your life. Incontinence is much more common in women than in men. This is often related to pregnancy, childbirth and menopause. Each of these experiences can cause a woman’s pelvic support muscles to weaken over time.

You’re also more likely to experience incontinence as you get older. The muscles that support your pelvic organs can become weaker over time, causing you to experience leakage issues.

Am I at a higher risk of incontinence at an older age?

Your body constantly changes throughout your life. As you age, the muscles that support your pelvic organs can weaken. This means that your bladder and urethra have less support — often leading to urine leakage. Your risk for developing incontinence as you age might be higher if you have a chronic health condition, have given birth to children, went through menopause, have an enlarged prostate or have had prostate cancer surgery. It’s important to talk to your healthcare provider over time about the risks of incontinence and ways you can manage it without interference to your daily life.

Is incontinence more common in women?

Incontinence is much more commonly seen in women than in men. A large part of this is because of pregnancy, childbirth and menopause. Each of these events in a woman’s life can lead to bladder control issues. Pregnancy can be a short-term cause of incontinence and the bladder control issues typically get better after the baby is born. Some women experience incontinence after delivery because of the strain childbirth takes on the pelvic floor muscles. When these muscles are weakened, you’re more likely to experience leakage issues. Menopause causes your body to go through a lot of change. Your hormones (estrogen in particular) change during menopause and this can alter your bladder control.

Men can also experience incontinence, but it isn’t as common as it is in women.

Symptoms and Causes

What causes incontinence?

There are many different reasons that you could experience incontinence. These causes can vary depending on if you’re a woman or man. Some causes are temporary health conditions that usually go away once treated. In those cases, your incontinence also usually stops once the condition is treated. Incontinence can be caused by long-term (chronic) medical conditions. When you experience leakage issues because of a chronic condition, it’s usually something you will have to manage over a longer period of time. Even with treatment, chronic conditions usually don’t go away. Incontinence may have to be managed over time as a symptom of your chronic condition.

Temporary or short-term causes of incontinence can include:

  • Urinary tract infections (UTIs): An infection inside your urinary tract (urethra, ureters, bladder and kidneys) can cause pain and increase your need to pee more often. Once treated, the urge to urinate frequently usually goes away.
  • Pregnancy: During pregnancy, your uterus places extra pressure on the bladder as it expands. Most women who experience incontinence during pregnancy notice that it goes away in the weeks after delivery.
  • Medications: Incontinence can be a side effect of certain medications, including diuretics and antidepressants.
  • Beverages: There are certain drinks — like coffee and alcohol — that can make you need to urinate much more often. If you stop drinking these beverages, your need to urinate frequently typically goes down.
  • Constipation: Chronic constipation (stool that’s hard and dry) can cause you to have bladder control issues.

Chronic or long-term causes of incontinence can include:

  • Pelvic floor disorders: When you have an issue with your pelvic floor muscles, it can impact the way your organs function, including your bladder.
  • Stroke: A stroke can cause you to experience issues with muscle control. This can include the muscles that control your urinary system.
  • Diabetes: When you have diabetes, your body produces more urine. This increase in the amount of urine can cause leakage issues. In addition, peripheral neuropathy can affect the bladder’s function.
  • Menopause: Menopause is another time of change in a woman’s body when hormone levels change rapidly and pelvic floor muscles can also become weaker — something that also can happen as you get older.
  • Multiple sclerosis (MS): If you have MS, you may experience a loss of control with your bladder, leading to leakage issues.
  • Enlarged prostate: When the prostate is larger than normal, it can cause several bladder control issues. You might also hear this condition called benign prostatic hyperplasia, or BPH.
  • After prostate cancer surgery: During prostate cancer surgery the sphincter muscle can sometimes be damaged leading to stress incontinence.

Why does pregnancy cause incontinence?

During pregnancy, your body goes through a lot of physical changes. As your uterus stretches to hold the growing baby, a few things happen. Your bladder can be squished by the expanding baby, making your bladder hold less than before. You might experience an increased urgency to pee during pregnancy because your bladder cannot hold as much as before. This might become even more challenging towards the end of pregnancy when the baby is at its largest.

Another reason for incontinence during pregnancy is the weakening of your pelvic floor muscles. These muscles are the support structures for all of the organs in your pelvis. During pregnancy, they can be stretched and weakened as your uterus expands.

What are the symptoms of incontinence?

The main symptom of incontinence is a leakage of urine. This could be a constant dripping of urine or an occasional experience of leakage. If you have incontinence, you might have large amounts or small amounts of leaked urine. You might experience leakage for a wide variety of reasons — often depending on the type of incontinence you have.

You might leak urine when you:

  • Exercise.
  • Cough.
  • Laugh.
  • Sneeze.
  • Have an urge to urinate, but can’t make it to the toilet on time.
  • Have to get up in the middle of night to urinate (nocturia).

Diagnosis and Tests

How is incontinence diagnosed?

Often, the diagnosis process for incontinence will start with a conversation with your healthcare provider about your medical history and bladder control issues. Your provider might ask you questions like:

  • How often do you urinate?
  • Do you leak urine between trips to the toilet, how often does this happen and how much urine do you leak each time?
  • How long have you been experiencing incontinence?

These questions can help your provider figure out a pattern with your leakage, which often points to a specific type of incontinence. When your provider is asking about your medical history, it’s important to list all of your medications because some medications can cause incontinence. Your provider will also ask about any past pregnancies and the details around each delivery.

There are also several specific tests that your provider might do to diagnose incontinence, including:

  • Physical exam: Your healthcare provider will typically do a physical exam early in the diagnosis process. During this exam, your provider will look for any physical reason that could be causing your incontinence. This could include doing a pelvic exam if you’re a woman or checking the size of a man’s prostate.
  • Urine samples: Your provider may take samples of your urine to test for infections or blood. Testing your urine is also called urinalysis.
  • An ultrasound of your bladder: An ultrasound is a painless test that uses sound waves to create an image of your internal organs. This imaging test will allow your provider to look at the contents of your bladder and assess the emptying ability of your bladder in a non-invasive way.
  • Stress test: During this test, your provider will ask you to cough to see if any urine leaks from this action. If you’ve noticed leakage during other activities, like running or jumping, your provider may ask you to repeat those actions to see if you have a leakage issue.
  • Cystoscopy: A cystoscope is a thin flexible tube with a camera on the end that can be inserted into your urethra and bladder to get a close look at the inside of your urinary tract. This tool allows your provider to see a lot of detail inside your body.
  • Urodynamic testing: This testing involves several tests that check how much your bladder can hold and how well your urethral sphincter muscle (the muscle that holds your urethra shut) is working. One part of this testing may involve inserting a tube into your bladder that will fill the bladder up with fluid. This checks how much your bladder can actually hold.
  • Pad test: Your provider may give you a pad to wear, which will catch any leaked urine. At the end of the test, this pad will be checked to see how much urine you lost.

While at home, your provider might recommend you keep track of any leakage in a journal for a few days. By writing down how often you experience incontinence issues over the span of a few days, your provider might be able to identify a pattern. This can really help in the diagnosis process. Make sure to write down how often you need to urinate, how much you are able to go each time, if you leak between trips to the bathroom and any activities you might be doing when you leak urine. You’ll then bring this journal with you to your appointment and talk about it with your provider.

When should I see a doctor about incontinence?

It’s important to know that incontinence can be treated. Many people believe that it’s something that just goes along with aging and is an unavoidable issue. If you find that incontinence is disturbing your daily activities and causing you to miss out on things you typically enjoy, talk to your healthcare provider. There are a wide range of options to treat incontinence.

Management and Treatment

How is incontinence treated?

There are many different factors that your healthcare provider will consider when creating a treatment plan for your incontinence. The type of incontinence and the ways it affects your life are both big considerations. Your provider will also talk to you about the type of treatment you are most comfortable with. There are three main types of treatment you can explore for incontinence — medications, lifestyle changes and surgery. Each option has pros and cons that your provider will discuss with you.

Medications to treat incontinence

There are quite a few medications that can reduce leakage. Some of these drugs stabilize the muscle contractions that cause problems with an overactive bladder. Other medications actually do the opposite thing — relaxing muscles to allow your bladder to empty completely. Hormone replacement therapies can — often involving replacing estrogen that’s decreased during menopause — may also help restore normal bladder function.

In many cases, medications can work very well to return normal function to the bladder. Your provider will carefully select a medication that matches your specific needs. Often, your provider will start you on a low dose of the medication and then increase it slowly. This is done to try and reduce your risks of side effects and to keep track of how well the medication is working to treat your incontinence.

Common medications that can be used to treat incontinence include:

  • Oxybutynin (Ditropan®), oxybutynin XL (Ditropan XL®), oxybutynin TDDS (Oxytrol®).
  • Tolterodine (Detrol®).
  • Solifenacin (Vesicare®).
  • Fesoterodine (Toviaz®).
  • Darifenacin (Enablex®).
  • Trospium (Sanctura XR®).
  • Antidepressant medication — Imipramine (Norfranil, Tipramine, Trofranil).
  • Mirabegron (Myrbetriq®).

Lifestyle changes to manage incontinence

Sometimes, there are changes to your everyday life that can actually help your incontinence. These changes often include exercises you can do to strengthen your pelvic floor muscles, changes to your normal habits and an improved diet. Some people notice improvements by making these changes at home and don’t need additional treatment.

Talk to your healthcare provider about these home treatment options for incontinence before starting any of them. You might not be able to treat all types of incontinence with these lifestyle changes. Your provider might also make detailed suggestions to you about the best lifestyle changes to try given your incontinence diagnosis.

Lifestyle changes to help improve incontinence can include:

  • Emptying your bladder on a regular schedule. This is also called timed voidings — a practice of going to the bathroom on a regular schedule instead of waiting for the urge to go.
  • Emptying your bladder before physical activities. If you’re planning to exercise or do a physical activity, plan to empty your bladder before the activity starts to avoid leakage.
  • Avoiding lifting heavy objects. If you need to move something large, grab an additional person to help you.
  • Doing regular Kegel exercises to help strengthen your pelvic floor muscles.
  • Avoiding drinking caffeine or a lot of fluids before staring an activity. If you experience frequent urination and leakage at night, you might also want to avoid drinking beverages right before bed.
  • Wearing pads and products that are designed to catch any leaked urine can also be a useful way to manage incontinence. These products can usually be worn under your clothes without anyone noticing and they provide reassurance that you won’t experience urine leaking through your clothes.
  • Practicing bladder training to help stretch out the amount of time between each trip to the bathroom. The goal in bladder training is to try and wait a little longer between urinating each time to build up strength.
  • Maintaining a healthy body weight. Having excess body weight can be one cause of incontinence. By eating a healthy diet and exercising, you can reduce the risk of incontinence.

There are also devices that you can use at home to help with incontinence. One over-the-counter device that you can use is a:

  • Vaginal insert: There are over-the-counter devices that can be placed in the vagina that can compress the urethra and help reduce stress incontinence in women.

Procedures and surgeries to treat incontinence

If other non-invasive treatment options have failed to treat your incontinence, there are several procedures that your provider might suggest. These procedures range from simple injections to more complicated surgeries. Your provider will discuss the best procedural option for you based on the type of incontinence you have and your symptoms.

Procedures to treat incontinence can include:

  • Bulking agents: This treatment option is an injection that’s typically used in women with stress incontinence. A permanent substance is injected into the lining of your urethra to help increase the size of the urethra’s lining.
  • Botulinum toxin injections (Botox®): You might think of Botox® as a cosmetic treatment, but it can also be used to relax muscles in your body. Your provider might inject Botox® into your bladder to help relax the muscles — helping with urge incontinence. This treatment isn’t permanent and will need to be repeated over time.
  • Neuromodulation devices: Pacemakers that stimulate the nerves to the bladder to improve control can be implanted. Furthermore, a nerve near your ankle can be stimulated to achieve better bladder control.
  • Sling procedures: There are sling procedures to treat incontinence for both men and women. In women, either a synthetic material or strip of your own tissue is typically used to support the urethral channel.
  • Artificial urethral sphincter: This is a device that’s used in men with stress incontinence that is placed to close the urethra when not urinating. It’s typically used for leakage after prostate cancer surgery.

How do I do Kegel exercises?

Kegel exercises are a simple way to build strength in your pelvic floor muscles. These exercises are done by lifting, holding and then relaxing your pelvic floor muscles. You can find these muscles by stopping the flow of urine mid-stream while you’re urinating. Only do this until you learn how to find the muscles — stopping the flow of urine mid-stream isn’t healthy over a long period of time.

When you’re doing Kegel exercises, start small. Only hold it for a few second. Over time you can slowly work your way up to longer and longer stretches of holding the muscles tight.

Unlike other types of workouts, no one can tell when you’re doing Kegel exercises. Aim to do several sets of Kegel exercises (a set is made up of 10 exercises) twice a day.

Prevention

Can incontinence be prevented?

Different events throughout your life can lead to many of the things that cause incontinence. The muscles that support your pelvic organs can weaken over time. For women, these muscles can also be weakened by big life events like pregnancy and childbirth. However, in the same way you work out to build strength in your legs or arms, you can do exercises to strengthen your pelvic floor muscles. Doing exercises to strengthen your pelvic muscles may not prevent you from having any issues with incontinence, but it can help you regain control of your bladder. Maintaining a healthy body weight can also help with bladder control. Talk to your healthcare provider about the best ways to maintain strong pelvic floor muscles throughout your life.

Outlook / Prognosis

Will I have incontinence for my entire life?

Sometimes incontinence is a short-term issue that will go away once the cause ends. This is often the case when you have a condition like a urinary tract infection (UTI). Once treated, frequent urination and leakage problems caused by a UTI typically end. This is also true for some women who experience bladder control issues during pregnancy. For many, the issues end in the weeks after delivery. However, other causes of incontinence are long-term and related to conditions that are managed throughout your life. If you have a chronic condition like diabetes or multiple sclerosis, you may have incontinence for a long period of time. In those cases, it’s important to talk to your provider about the best ways to manage your incontinence so that it doesn’t interfere with your life.

A note from Cleveland Clinic

It can be embarrassing to talk about bathroom habits with your healthcare provider. This embarrassment shouldn’t stop you from treating incontinence, though. Often, your healthcare provider can help figure out the cause of your bladder control issue and help make it better. You don’t need to deal with it alone. Talk to your healthcare provider about the best ways to treat incontinence so that you can lead a full and active life without worrying about leakage.

Leakage, Causes, Diagnosis, Treatment & Prevention

Overview

What is incontinence?

Urinary incontinence is a condition that impacts many people’s lives. When you have incontinence, you may experience bladder control issues and leak urine. This leakage is often uncontrollable and can negatively impact your life.

Your urinary system is made up of the kidneys, ureters, bladder and urethra. These parts do several jobs. They filter, store and remove waste from your body. Your kidneys are the filters of your body. Waste products are removed from your blood by the kidneys, creating urine. The urine then moves down through two thin tubes called the ureters. The ureters connect to the bladder, where the urine will collect until it’s time to leave the body. Your bladder is like a storage tank — once the bladder is full, the brain sends a signal that it’s time to urinate. Urine then leaves the bladder when a muscle opens up (sphincter), allowing the urine to flow freely out of the body through the urethra.

When this system is working smoothly, you usually have time to get to a bathroom before needing to urinate and you don’t experience any leakage of urine. Urinary incontinence can happen when these parts don’t operate as they should. This can happen for many different reasons throughout your life.

Many people think that incontinence is a normal part of aging that can’t be helped. While it is true that your risk of incontinence increases as you get older, there are also treatments available to help you manage this condition. Incontinence doesn’t have to disrupt your life and keep you from being active.

What are the different types of incontinence?

There are several different types of incontinence. These types have different causes, characteristics and triggers for urine leakage. Knowing the type of incontinence is often an important part of the diagnosis and treatment plan for incontinence.

The types of incontinence include:

  • Urge incontinence: This type of incontinence is characterized by an intense need to urinate right away. Often, this happens too quickly for you to make it to a toilet and you end up leaking urine. Urge incontinence can be caused by a condition called overactive bladder (OAB). You could have OAB for a variety of reasons like having weak pelvic muscles, nerve damage, an infection, low levels of estrogen after menopause or a heavier body weight. Some medications and beverages like alcohol and caffeine can also cause OAB.
  • Stress incontinence: When you leak urine during activities, this is often stress incontinence. In this type of incontinence, your pelvic floor muscles are weak and no longer support your pelvic organs as they should. This muscle weakness means that you’re more likely to accidently leak urine when you move around. For many people, leakage issues happen when they laugh, cough, sneeze, run, jump or lift things. These actions all place pressure on your bladder. Without the support of strong pelvic muscles, you’re more likely to leak urine. Women who have given birth are at a higher risk of having stress incontinence. Men who have had prostate surgery may develop stress incontinence.
  • Overflow incontinence: If your bladder doesn’t empty completely each time you urinate, you could have overflow incontinence. Think of the bladder as a juice jug. If you only pour some of the juice out of the jug, but not all of it, there’s still a risk that you could spill when you move around. People with overflow incontinence never completely empty the bladder — placing them at risk for a spill. Usually, this results in small amounts of urine dripping out over time instead of one big gush of urine. This type of incontinence is more common in people with chronic conditions like multiple sclerosis (MS), stroke or diabetes. This may also occur in men with a large prostate.
  • Mixed incontinence: This type of incontinence is a combination of several problems that all lead to leakage issues. When you have mixed incontinence, you might be dealing with stress incontinence and an overactive bladder. It’s often important to pay attention to what you’re doing when you have leakage issues with this type of incontinence. Identifying what triggers mixed incontinence is usually the best way to manage it.

Who gets incontinence?

Incontinence can happen to anyone. However, it’s more common in certain groups and at certain times in your life. Incontinence is much more common in women than in men. This is often related to pregnancy, childbirth and menopause. Each of these experiences can cause a woman’s pelvic support muscles to weaken over time.

You’re also more likely to experience incontinence as you get older. The muscles that support your pelvic organs can become weaker over time, causing you to experience leakage issues.

Am I at a higher risk of incontinence at an older age?

Your body constantly changes throughout your life. As you age, the muscles that support your pelvic organs can weaken. This means that your bladder and urethra have less support — often leading to urine leakage. Your risk for developing incontinence as you age might be higher if you have a chronic health condition, have given birth to children, went through menopause, have an enlarged prostate or have had prostate cancer surgery. It’s important to talk to your healthcare provider over time about the risks of incontinence and ways you can manage it without interference to your daily life.

Is incontinence more common in women?

Incontinence is much more commonly seen in women than in men. A large part of this is because of pregnancy, childbirth and menopause. Each of these events in a woman’s life can lead to bladder control issues. Pregnancy can be a short-term cause of incontinence and the bladder control issues typically get better after the baby is born. Some women experience incontinence after delivery because of the strain childbirth takes on the pelvic floor muscles. When these muscles are weakened, you’re more likely to experience leakage issues. Menopause causes your body to go through a lot of change. Your hormones (estrogen in particular) change during menopause and this can alter your bladder control.

Men can also experience incontinence, but it isn’t as common as it is in women.

Symptoms and Causes

What causes incontinence?

There are many different reasons that you could experience incontinence. These causes can vary depending on if you’re a woman or man. Some causes are temporary health conditions that usually go away once treated. In those cases, your incontinence also usually stops once the condition is treated. Incontinence can be caused by long-term (chronic) medical conditions. When you experience leakage issues because of a chronic condition, it’s usually something you will have to manage over a longer period of time. Even with treatment, chronic conditions usually don’t go away. Incontinence may have to be managed over time as a symptom of your chronic condition.

Temporary or short-term causes of incontinence can include:

  • Urinary tract infections (UTIs): An infection inside your urinary tract (urethra, ureters, bladder and kidneys) can cause pain and increase your need to pee more often. Once treated, the urge to urinate frequently usually goes away.
  • Pregnancy: During pregnancy, your uterus places extra pressure on the bladder as it expands. Most women who experience incontinence during pregnancy notice that it goes away in the weeks after delivery.
  • Medications: Incontinence can be a side effect of certain medications, including diuretics and antidepressants.
  • Beverages: There are certain drinks — like coffee and alcohol — that can make you need to urinate much more often. If you stop drinking these beverages, your need to urinate frequently typically goes down.
  • Constipation: Chronic constipation (stool that’s hard and dry) can cause you to have bladder control issues.

Chronic or long-term causes of incontinence can include:

  • Pelvic floor disorders: When you have an issue with your pelvic floor muscles, it can impact the way your organs function, including your bladder.
  • Stroke: A stroke can cause you to experience issues with muscle control. This can include the muscles that control your urinary system.
  • Diabetes: When you have diabetes, your body produces more urine. This increase in the amount of urine can cause leakage issues. In addition, peripheral neuropathy can affect the bladder’s function.
  • Menopause: Menopause is another time of change in a woman’s body when hormone levels change rapidly and pelvic floor muscles can also become weaker — something that also can happen as you get older.
  • Multiple sclerosis (MS): If you have MS, you may experience a loss of control with your bladder, leading to leakage issues.
  • Enlarged prostate: When the prostate is larger than normal, it can cause several bladder control issues. You might also hear this condition called benign prostatic hyperplasia, or BPH.
  • After prostate cancer surgery: During prostate cancer surgery the sphincter muscle can sometimes be damaged leading to stress incontinence.

Why does pregnancy cause incontinence?

During pregnancy, your body goes through a lot of physical changes. As your uterus stretches to hold the growing baby, a few things happen. Your bladder can be squished by the expanding baby, making your bladder hold less than before. You might experience an increased urgency to pee during pregnancy because your bladder cannot hold as much as before. This might become even more challenging towards the end of pregnancy when the baby is at its largest.

Another reason for incontinence during pregnancy is the weakening of your pelvic floor muscles. These muscles are the support structures for all of the organs in your pelvis. During pregnancy, they can be stretched and weakened as your uterus expands.

What are the symptoms of incontinence?

The main symptom of incontinence is a leakage of urine. This could be a constant dripping of urine or an occasional experience of leakage. If you have incontinence, you might have large amounts or small amounts of leaked urine. You might experience leakage for a wide variety of reasons — often depending on the type of incontinence you have.

You might leak urine when you:

  • Exercise.
  • Cough.
  • Laugh.
  • Sneeze.
  • Have an urge to urinate, but can’t make it to the toilet on time.
  • Have to get up in the middle of night to urinate (nocturia).

Diagnosis and Tests

How is incontinence diagnosed?

Often, the diagnosis process for incontinence will start with a conversation with your healthcare provider about your medical history and bladder control issues. Your provider might ask you questions like:

  • How often do you urinate?
  • Do you leak urine between trips to the toilet, how often does this happen and how much urine do you leak each time?
  • How long have you been experiencing incontinence?

These questions can help your provider figure out a pattern with your leakage, which often points to a specific type of incontinence. When your provider is asking about your medical history, it’s important to list all of your medications because some medications can cause incontinence. Your provider will also ask about any past pregnancies and the details around each delivery.

There are also several specific tests that your provider might do to diagnose incontinence, including:

  • Physical exam: Your healthcare provider will typically do a physical exam early in the diagnosis process. During this exam, your provider will look for any physical reason that could be causing your incontinence. This could include doing a pelvic exam if you’re a woman or checking the size of a man’s prostate.
  • Urine samples: Your provider may take samples of your urine to test for infections or blood. Testing your urine is also called urinalysis.
  • An ultrasound of your bladder: An ultrasound is a painless test that uses sound waves to create an image of your internal organs. This imaging test will allow your provider to look at the contents of your bladder and assess the emptying ability of your bladder in a non-invasive way.
  • Stress test: During this test, your provider will ask you to cough to see if any urine leaks from this action. If you’ve noticed leakage during other activities, like running or jumping, your provider may ask you to repeat those actions to see if you have a leakage issue.
  • Cystoscopy: A cystoscope is a thin flexible tube with a camera on the end that can be inserted into your urethra and bladder to get a close look at the inside of your urinary tract. This tool allows your provider to see a lot of detail inside your body.
  • Urodynamic testing: This testing involves several tests that check how much your bladder can hold and how well your urethral sphincter muscle (the muscle that holds your urethra shut) is working. One part of this testing may involve inserting a tube into your bladder that will fill the bladder up with fluid. This checks how much your bladder can actually hold.
  • Pad test: Your provider may give you a pad to wear, which will catch any leaked urine. At the end of the test, this pad will be checked to see how much urine you lost.

While at home, your provider might recommend you keep track of any leakage in a journal for a few days. By writing down how often you experience incontinence issues over the span of a few days, your provider might be able to identify a pattern. This can really help in the diagnosis process. Make sure to write down how often you need to urinate, how much you are able to go each time, if you leak between trips to the bathroom and any activities you might be doing when you leak urine. You’ll then bring this journal with you to your appointment and talk about it with your provider.

When should I see a doctor about incontinence?

It’s important to know that incontinence can be treated. Many people believe that it’s something that just goes along with aging and is an unavoidable issue. If you find that incontinence is disturbing your daily activities and causing you to miss out on things you typically enjoy, talk to your healthcare provider. There are a wide range of options to treat incontinence.

Management and Treatment

How is incontinence treated?

There are many different factors that your healthcare provider will consider when creating a treatment plan for your incontinence. The type of incontinence and the ways it affects your life are both big considerations. Your provider will also talk to you about the type of treatment you are most comfortable with. There are three main types of treatment you can explore for incontinence — medications, lifestyle changes and surgery. Each option has pros and cons that your provider will discuss with you.

Medications to treat incontinence

There are quite a few medications that can reduce leakage. Some of these drugs stabilize the muscle contractions that cause problems with an overactive bladder. Other medications actually do the opposite thing — relaxing muscles to allow your bladder to empty completely. Hormone replacement therapies can — often involving replacing estrogen that’s decreased during menopause — may also help restore normal bladder function.

In many cases, medications can work very well to return normal function to the bladder. Your provider will carefully select a medication that matches your specific needs. Often, your provider will start you on a low dose of the medication and then increase it slowly. This is done to try and reduce your risks of side effects and to keep track of how well the medication is working to treat your incontinence.

Common medications that can be used to treat incontinence include:

  • Oxybutynin (Ditropan®), oxybutynin XL (Ditropan XL®), oxybutynin TDDS (Oxytrol®).
  • Tolterodine (Detrol®).
  • Solifenacin (Vesicare®).
  • Fesoterodine (Toviaz®).
  • Darifenacin (Enablex®).
  • Trospium (Sanctura XR®).
  • Antidepressant medication — Imipramine (Norfranil, Tipramine, Trofranil).
  • Mirabegron (Myrbetriq®).

Lifestyle changes to manage incontinence

Sometimes, there are changes to your everyday life that can actually help your incontinence. These changes often include exercises you can do to strengthen your pelvic floor muscles, changes to your normal habits and an improved diet. Some people notice improvements by making these changes at home and don’t need additional treatment.

Talk to your healthcare provider about these home treatment options for incontinence before starting any of them. You might not be able to treat all types of incontinence with these lifestyle changes. Your provider might also make detailed suggestions to you about the best lifestyle changes to try given your incontinence diagnosis.

Lifestyle changes to help improve incontinence can include:

  • Emptying your bladder on a regular schedule. This is also called timed voidings — a practice of going to the bathroom on a regular schedule instead of waiting for the urge to go.
  • Emptying your bladder before physical activities. If you’re planning to exercise or do a physical activity, plan to empty your bladder before the activity starts to avoid leakage.
  • Avoiding lifting heavy objects. If you need to move something large, grab an additional person to help you.
  • Doing regular Kegel exercises to help strengthen your pelvic floor muscles.
  • Avoiding drinking caffeine or a lot of fluids before staring an activity. If you experience frequent urination and leakage at night, you might also want to avoid drinking beverages right before bed.
  • Wearing pads and products that are designed to catch any leaked urine can also be a useful way to manage incontinence. These products can usually be worn under your clothes without anyone noticing and they provide reassurance that you won’t experience urine leaking through your clothes.
  • Practicing bladder training to help stretch out the amount of time between each trip to the bathroom. The goal in bladder training is to try and wait a little longer between urinating each time to build up strength.
  • Maintaining a healthy body weight. Having excess body weight can be one cause of incontinence. By eating a healthy diet and exercising, you can reduce the risk of incontinence.

There are also devices that you can use at home to help with incontinence. One over-the-counter device that you can use is a:

  • Vaginal insert: There are over-the-counter devices that can be placed in the vagina that can compress the urethra and help reduce stress incontinence in women.

Procedures and surgeries to treat incontinence

If other non-invasive treatment options have failed to treat your incontinence, there are several procedures that your provider might suggest. These procedures range from simple injections to more complicated surgeries. Your provider will discuss the best procedural option for you based on the type of incontinence you have and your symptoms.

Procedures to treat incontinence can include:

  • Bulking agents: This treatment option is an injection that’s typically used in women with stress incontinence. A permanent substance is injected into the lining of your urethra to help increase the size of the urethra’s lining.
  • Botulinum toxin injections (Botox®): You might think of Botox® as a cosmetic treatment, but it can also be used to relax muscles in your body. Your provider might inject Botox® into your bladder to help relax the muscles — helping with urge incontinence. This treatment isn’t permanent and will need to be repeated over time.
  • Neuromodulation devices: Pacemakers that stimulate the nerves to the bladder to improve control can be implanted. Furthermore, a nerve near your ankle can be stimulated to achieve better bladder control.
  • Sling procedures: There are sling procedures to treat incontinence for both men and women. In women, either a synthetic material or strip of your own tissue is typically used to support the urethral channel.
  • Artificial urethral sphincter: This is a device that’s used in men with stress incontinence that is placed to close the urethra when not urinating. It’s typically used for leakage after prostate cancer surgery.

How do I do Kegel exercises?

Kegel exercises are a simple way to build strength in your pelvic floor muscles. These exercises are done by lifting, holding and then relaxing your pelvic floor muscles. You can find these muscles by stopping the flow of urine mid-stream while you’re urinating. Only do this until you learn how to find the muscles — stopping the flow of urine mid-stream isn’t healthy over a long period of time.

When you’re doing Kegel exercises, start small. Only hold it for a few second. Over time you can slowly work your way up to longer and longer stretches of holding the muscles tight.

Unlike other types of workouts, no one can tell when you’re doing Kegel exercises. Aim to do several sets of Kegel exercises (a set is made up of 10 exercises) twice a day.

Prevention

Can incontinence be prevented?

Different events throughout your life can lead to many of the things that cause incontinence. The muscles that support your pelvic organs can weaken over time. For women, these muscles can also be weakened by big life events like pregnancy and childbirth. However, in the same way you work out to build strength in your legs or arms, you can do exercises to strengthen your pelvic floor muscles. Doing exercises to strengthen your pelvic muscles may not prevent you from having any issues with incontinence, but it can help you regain control of your bladder. Maintaining a healthy body weight can also help with bladder control. Talk to your healthcare provider about the best ways to maintain strong pelvic floor muscles throughout your life.

Outlook / Prognosis

Will I have incontinence for my entire life?

Sometimes incontinence is a short-term issue that will go away once the cause ends. This is often the case when you have a condition like a urinary tract infection (UTI). Once treated, frequent urination and leakage problems caused by a UTI typically end. This is also true for some women who experience bladder control issues during pregnancy. For many, the issues end in the weeks after delivery. However, other causes of incontinence are long-term and related to conditions that are managed throughout your life. If you have a chronic condition like diabetes or multiple sclerosis, you may have incontinence for a long period of time. In those cases, it’s important to talk to your provider about the best ways to manage your incontinence so that it doesn’t interfere with your life.

A note from Cleveland Clinic

It can be embarrassing to talk about bathroom habits with your healthcare provider. This embarrassment shouldn’t stop you from treating incontinence, though. Often, your healthcare provider can help figure out the cause of your bladder control issue and help make it better. You don’t need to deal with it alone. Talk to your healthcare provider about the best ways to treat incontinence so that you can lead a full and active life without worrying about leakage.

Urinary Incontinence in Women | Michigan Medicine

Topic Overview

What is urinary incontinence?

Urinary incontinence is the accidental release of urine. It can happen when you cough, laugh, sneeze, or jog. Or you may have a sudden need to go to the bathroom but can’t get there in time. Bladder control problems are very common, especially among older adults. They usually don’t cause major health problems, but they can be embarrassing.

Incontinence can be a short-term problem caused by a urinary tract infection, a medicine, or constipation. It gets better when you treat the problem that is causing it. But this topic focuses on ongoing urinary incontinence.

There are two main kinds of urinary incontinence. Some women—especially older women—have both.

  • Stress incontinence occurs when you sneeze, cough, laugh, jog, or do other things that put pressure on your bladder. It is the most common type of bladder control problem in women.
  • Urge incontinence happens when you have a strong need to urinate but can’t reach the toilet in time. This can happen even when your bladder is holding only a small amount of urine. Some women may have no warning before they accidentally leak urine. Other women may leak urine when they drink water or when they hear or touch running water. Overactive bladder is a kind of urge incontinence. But not everyone with overactive bladder leaks urine.

What causes urinary incontinence?

Bladder control problems may be caused by:

  • Weak muscles in the lower urinary tract.
  • Problems or damage either in the urinary tract or in the nerves that control urination.

Stress incontinence can be caused by childbirth, weight gain, or other conditions that stretch the pelvic floor muscles. When these muscles can’t support your bladder properly, the bladder drops down and pushes against the vagina. You can’t tighten the muscles that close off the urethra. So urine may leak because of the extra pressure on the bladder when you cough, sneeze, laugh, exercise, or do other activities.

Urge incontinence is caused by an overactive bladder muscle that pushes urine out of the bladder. It may be caused by irritation of the bladder, emotional stress, or brain conditions such as Parkinson’s disease or stroke. Many times doctors don’t know what causes it.

What are the symptoms?

The main symptom is the accidental release of urine.

  • If you have stress incontinence, you may leak a small to medium amount of urine when you cough, sneeze, laugh, exercise, or do similar things.
  • If you have urge incontinence, you may feel a sudden urge to urinate and the need to urinate often. With this type of bladder control problem, you may leak a larger amount of urine that can soak your clothes or run down your legs.
  • If you have mixed incontinence, you may have symptoms of both problems.

How is urinary incontinence diagnosed?

Your doctor will ask about what and how much you drink. He or she will also ask how often and how much you urinate and leak. It may help to keep track of these things using a bladder diary for 3 or 4 days before you see your doctor.

Your doctor will examine you and may do some simple tests to look for the cause of your bladder control problem. If your doctor thinks it may be caused by more than one problem, you will likely have more tests.

How is it treated?

Treatments are different for each person. They depend on the type of incontinence you have and how much it affects your life. After your doctor knows what has caused the incontinence, your treatment may include exercises, bladder training, medicines, a pessary, or a combination of these. Some women may need surgery.

There are also some things you can do at home. In many cases, these lifestyle changes can be enough to control incontinence.

  • Cut back on caffeine drinks, such as coffee and tea. Also cut back on fizzy drinks like soda pop. And don’t drink more than one alcohol drink a day.
  • Eat foods high in fiber to help avoid constipation.
  • Don’t smoke. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
  • Stay at a healthy weight.
  • Try simple pelvic-floor exercises like Kegel exercises.
  • Go to the bathroom at several set times each day, and wear clothes that you can remove easily. Make your path to the bathroom as clear and quick as you can.
  • Keep track of your symptoms and any leaking of urine with a bladder diary. This can help you and your doctor find the best treatment for you.

If you have symptoms of urinary incontinence, don’t be embarrassed to tell your doctor. Most people can be helped or cured.

How can you prevent urinary incontinence?

Strengthening your pelvic muscles with Kegel exercises may lower your risk for incontinence.

If you smoke, try to quit. Quitting may make you cough less, which may help with incontinence.

Cause

Stress incontinence

Stress incontinence
is caused by conditions that stretch the pelvic floor muscles, such as:

When these muscles can’t support your bladder well, the bladder drops down and pushes against the vagina. Then you can’t tighten the muscles that usually close off the urethra. So urine may leak because of the extra pressure on the bladder when you cough, sneeze, laugh, exercise, or do other activities.

This is the most common type of urinary incontinence in women.

A chronic cough from smoking can make stress incontinence worse.

Urge incontinence

Urge incontinence
is caused when the bladder muscle involuntarily contracts and pushes urine out of the bladder. Many times doctors don’t know what causes this. But sometimes the cause is:

  • Irritation of the bladder.
  • Emotional stress.
  • Brain conditions such as Parkinson’s disease or stroke.

Overactive bladder is a kind of urge incontinence. But not everyone with overactive bladder leaks urine. For more information, see the topic Overactive Bladder.

Other types of incontinence

Less common types of urinary incontinence have other causes. These types include:

Symptoms

The main symptom of urinary incontinence is a problem controlling urination.

  • Symptoms of stress incontinence:
    • Involuntary release of urine, especially when you cough, sneeze, or laugh
    • Leaking a small to moderate amount of urine
  • Symptoms of urge incontinence:
    • Frequent and sudden uncontrollable need to urinate
    • May leak a moderate to large amount of urine, although a small amount is possible

It is common for a woman to have symptoms of both types of incontinence. This is called mixed incontinence.

What Happens

Urinary incontinence usually starts gradually and slowly becomes worse. As it gets worse, a woman may:

  • Avoid going out in public because of embarrassment.
  • Become less active.
  • Have physical problems caused by frequent urine contact. These problems may include irritation of the groin area and more frequent urinary tract infections.

Treating the cause of incontinence often gets rid of or controls these problems.

Some bladder problems are temporary. For example, you may have a urinary tract infection that causes incontinence, but the problem goes away after the infection is cured.

What Increases Your Risk

Sometimes several things combine to cause urinary incontinence. For example, a woman may have had multiple childbirths, be older, and have a severe cough because of chronic bronchitis or smoking. All of these might contribute to her incontinence problem.

Physical conditions that make urinary incontinence more likely include:

  • Pregnancy and vaginal delivery.
  • Having had a hysterectomy.
  • Obesity or being overweight.
  • Older age.
  • Bladder stones.
  • Structural abnormalities of the urinary tract.
  • Blockage of the bladder.
  • Chronic bladder infections.

Diseases and conditions that may cause urinary incontinence include:

  • Chronic cough due to smoking or bronchitis.
  • Pelvic organ prolapse.
  • Diabetes.
  • Parkinson’s disease.
  • Alzheimer’s disease.
  • Multiple sclerosis.
  • Bladder cancer.
  • Stroke.
  • Spinal cord injury.

Medicines and foods that may make urinary incontinence worse include:

  • Caffeinated and carbonated drinks, such as coffee, tea, and soda pop.
  • Alcohol drinks.
  • Prescription medicines that increase urine production (such as diuretics) or relax the bladder (such as anticholinergics and antidepressants).
  • Smoking.

When should you call your doctor?

Call your doctor if:

  • You have urinary incontinence that begins suddenly. This is called acute incontinence. It is often caused by urinary tract problems or medicines and can be easily corrected.
  • The involuntary release of urine is enough of a problem that you need to wear an absorbent pad, or if incontinence interferes with your life in any way.

Don’t be embarrassed to discuss urinary incontinence with your doctor. Urinary incontinence is not an inevitable result of aging. Most women with incontinence can be helped or cured.

Watchful waiting

If you have urinary incontinence that develops slowly, you may be able to control the problem yourself. If home treatment is not effective, or if incontinence interferes with your lifestyle, ask your doctor about other treatments.

Who to see

Health professionals who can diagnose and treat urinary incontinence include:

Your health professional may want you to see a urogynecologist.

If you need surgery, it is important to find a surgeon who is experienced in the types of surgical procedures used to treat incontinence.

Exams and Tests

To diagnose the cause of your urinary incontinence, your doctor will ask about your medical history and do a physical exam. It may be easier for you to answer questions if you keep a bladder diary for 3 or 4 days before you see your doctor.

To check for stress incontinence, your doctor may ask you to cough while you are standing.

Your doctor may also order these tests:

  • Bladder stress test and Bonney test
  • Pad test, which can help show how much urine is leaking. You are given an absorbent pad that has been weighed. You wear the pad until urine leaks, and then you return the pad to be weighed again. The increased weight of the pad gives an estimate of how much urine leaked.
  • Urinalysis and urine culture

Urodynamic testing

Urodynamic testing
is expensive. It is typically done only if surgery is being considered or if treatment has not worked for you and you need to know more about the cause. It provides a more advanced way to check bladder function.

The actual tests done in urodynamic testing often vary. They may include:

  • Cystometry, a series of tests to measure bladder pressure at different levels of fullness.
  • Postvoid residual (PVR) measurements, which measure the amount of urine that stays in your bladder after you urinate.
  • X-rays or ultrasound. These are used to examine changes in the position of the bladder and urethra during urination, coughing, or straining.

If the cause of incontinence is not identified by the above tests, more extensive tests may be needed.

Treatment Overview

Urinary incontinence isn’t an inevitable result of aging. Most women who have it can be helped or cured.

The best treatment depends on the cause of your incontinence and your personal preferences. Treatments include:

  • Behavioral training, such as bladder training and timed urination. For more information, see Other Treatment.
  • Lifestyle changes and pelvic floor (Kegel) exercises. For more information, see Home Treatment.
  • Medicines. For more information, see Medications.
  • Medical devices. For more information, see Other Treatment.
  • Surgery. For more information, see Surgery.

Behavioral training, exercises and lifestyle changes, and medicines are usually tried first. If the problem does not get better, your doctor may try another treatment or do more tests.

When there is more than one cause for incontinence, the most significant cause is treated first, followed by treatment for the secondary cause, if needed.

Prevention

You may reduce your chances for urinary incontinence by:

Home Treatment

If you have urinary incontinence, you can take some steps on your own that may stop or reduce the problem.

  • Set a schedule of urinating every 2 to 4 hours, regardless of whether you feel the need.
  • Talk with your doctor about all prescription and nonprescription medicines you take. Find out if any of them may be making your incontinence worse.
  • Use a bladder diary to keep track of your symptoms and any leaking of urine. Your diary can help you and your doctor find the best treatment for you.
  • If you have trouble reaching the bathroom before you urinate, try making a clearer, quicker path to the bathroom and wearing clothes that are easily removed (such as those with elastic waistbands or Velcro closures). Or keep a bedpan close to your bed or chair.
  • Wear a tampon while doing activities such as jogging or dancing to put a little pressure on your urethra and to temporarily slow or stop leakage. Or you may want to try to prevent leaks with a product like Poise Impressa, which you insert like a tampon.

Exercises

Pelvic floor (Kegel) exercises
can help women who have any type of urinary incontinence.footnote 1 These exercises are especially useful for stress incontinence. But they may also help urge incontinence.

Lifestyle changes

Losing weight often helps stress incontinence. Remember that effective weight-loss programs depend on a combination of diet and exercise.

Sometimes making lifestyle changes can help with urge incontinence. Try to identify any foods that might irritate your bladder—including citrus fruits, chocolate, tomatoes, vinegars, dairy products, aspartame, and spicy foods—and cut back on them. Also, avoid alcohol and caffeine.

If you smoke, try to quit. This may reduce coughing, which may reduce your problem with incontinence. For more information, see the topic Quitting Smoking.

Take steps to avoid constipation:

  • Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber.
  • Drink plenty of fluids, enough so that your urine is light yellow or clear like water.
  • Get some exercise every day. Try to do moderate activity at least 2½ hours a week. Or try to do vigorous activity at least 1¼ hours a week. It’s fine to be active in blocks of 10 minutes or more throughout your day and week.
  • Take a fiber supplement, such as Citrucel or Metamucil, every day if needed. Read and follow all instructions on the label.
  • Schedule time each day for a bowel movement. Having a daily routine may help. Take your time and don’t strain when having a bowel movement.

Medications

Not all forms of urinary incontinence are treated with medicines. In many cases, treatment with behavioral methods (bladder training, timed urination) and Kegel exercises are tried before medicines. These treatments, when combined with medicine, may help some women more than either treatment alone.

Medicines used to treat urge incontinence in women may include:

  • Anticholinergic and antispasmodic medicines, such as darifenacin, mirabegron, and oxybutynin. These calm the nerves that control bladder muscles and increase bladder capacity.
  • Vaginal estrogen.
  • Botox (botulinum toxin).

Surgery

There are several different kinds of surgeries to correct stress incontinence, which occurs when weakened pelvic floor muscles allow the bladder neck and urethra to drop. These surgeries seek to lift the urethra, the bladder, or both into the normal position. This makes sneezing, coughing, and laughing less likely to make urine leak from the bladder.

If other treatments (like pelvic floor muscle exercises) haven’t worked to control your incontinence, surgery may be your best option. What kind of surgery you have depends on your preference, your health, and your doctor’s experience.

Mixed incontinence means you have both stress incontinence and urge incontinence. Surgery may help women who have mixed incontinence. If surgery works to reduce the stress symptoms, often the urge symptoms cause less bother.

Surgery choices

Other Treatment

Other types of treatment for urinary incontinence include:

  • Behavioral methods
    . These are often the first thing to try. They often work well. They include:

    • Bladder training (also called bladder retraining). This is used to treat urge incontinence. With bladder training, you slowly increase how long you can wait before having to urinate by trying to delay urination after you get the urge to go.
    • Biofeedback. This is a technique for learning to control a body function that is not normally under conscious control. It is usually used to teach pelvic floor muscle exercises.
    • Pelvic floor muscle exercises (Kegels). Kegel exercises can help strengthen some of the muscles that control the flow of urine. These exercises are used to treat urge or stress incontinence.
  • Acupuncture
    . There isn’t a lot of evidence for how well acupuncture works for urinary incontinence. In one study, comparing bladder-specific acupuncture to sham acupuncture, both groups had less incontinence. But the group with bladder-specific acupuncture didn’t have as many episodes of urgency.footnote 2

  • Mechanical devices, such as a pessary.
  • Absorbent products
    , such as diapers.

Before trying behavioral methods or exercise for urinary incontinence, ask your doctor the following questions:

  • Is behavioral or exercise therapy alone likely to restore bladder control? Mild to moderate cases of common types of incontinence can be cured or greatly improved by these methods.
  • How long should I try behavioral or exercise techniques before I consider surgery or other treatment methods? Techniques like Kegel exercises don’t limit future treatment options (and they may even improve the odds of success for other treatments). So it is best to set a length of time after which the improvement can be evaluated.
  • Can I use exercises or behavioral methods along with medicine if medicine treatment is recommended? It may be possible to take medicine for a shorter time or to reduce the amount of medicines used if other methods of treatment are combined with medicine.

References

Citations

  1. Dumoulin C, Hay-Smith J (2010). Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews (1).
  2. Emmons SL, Otto L (2005). Acupuncture for overactive bladder. Obstetrics and Gynecology, 106(1): 138–143.

Other Works Consulted

  • Barber MD, et al. (2008). Transobturator tape compared with tension-free vaginal tape for the treatment of stress urinary incontinence. Obstetrics and Gynecology, 111(3): 611–621.
  • Garley AD, Noor N (2014). Diagnosis and surgical treatment of stress urinary incontinence. Obstetrics and Gynecology, 124(5): 1011–1027. DOI: 10.1097/AOG.0000000000000514. Accessed August 17, 2015.
  • Hartmann KE, et al. (2009). Treatment of Overactive Bladder in Women. Evidence Report/Technology Assessment No. 187 (AHRQ Publication No. 09-E017). Available online: http://www.ahrq.gov/clinic/tp/bladdertp.htm.
  • Kirchin V, et al. (2012). Urethral injection therapy for urinary incontinence in women. Cochrane Database of Systematic Reviews (2).
  • Naumann M, et al. (2008). Assessment: Botulinum neurotoxin in the treatment of autonomic disorders and pain (an evidence-based review): Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology, 70(19): 1707–1714.
  • Shamliyan TA, et al. (2008). Systematic review: Randomized, controlled trials of nonsurgical treatments for urinary incontinence in women. Annals of Internal Medicine, 148(6): 1–15.
  • Sung VW, et al. (2007). Comparison of retropubic vs transobturator approach to midurethral slings: A systematic review. American Journal of Obstetrics and Gynecology, 197(1): 3–11.
  • Tanagho EA, et al. (2008). Urinary incontinence. In EA Tanagho, JW McAninch, eds., Smith’s General Urology, 17th ed., pp. 473–489. New York: McGraw-Hill Medical.
  • Waetjen LE, et al. (2008). Factors associated with worsening and improving urinary incontinence across the menopausal transition. Obstetrics and Gynecology, 111(3): 667–677.

Credits

Current as of:
July 17, 2020

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD – Internal Medicine
Adam Husney MD – Family Medicine
Kathleen Romito MD – Family Medicine
Avery L. Seifert MD – Urology

Bladder Leakage? 3 Things Women Should Know About Urinary Incontinence

To help overcome the stigma, Fairchild shared three facts about urinary incontinence that all women should know.

1. There are different types.

If you experience incontinence when you sneeze, cough, or exercise, you may have stress incontinence, which is leakage from added pressure on the abdomen that pushes urine past the urethra.

If you stand up and are unable to hold off on emptying your bladder before you reach the bathroom, you may have urge incontinence, otherwise known as an overactive bladder.

Many women have a combination of stress and urge incontinence called mixed incontinence. And although less likely, some women experience overflow, a rare condition which causes frequent urinary leaks due to a constant full bladder.

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2. It could be a sign of an underlying condition.

Naturally, later in life, people can experience incontinence because of increased production of urine related to aging kidneys. Bladder function is also heavily impacted by changing bladder capacity and chronic medical conditions like diabetes, says Fairchild. Chronic straining, coughing and/or constipation can all put stress on the bladder, she explains.

But leakage can also be sign of a more serious, underlying health condition, according to a 2018 National Poll on Healthy Aging.” For example, poor heart function could be the culprit behind frequent urination while sleeping.

“If fluid is pooling in your legs during the day, when you lay down, that fluid redistributes and increases urine production,” says Fairchild.

Although bladder leakage is common, discuss your particular symptoms with your doctor.

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3. Treatment options exist.

And they’re not all invasive or surgical.

Small behavioral changes, like bladder training, eating more fiber to reduce constipation, decreasing the amount of fluids you drink, or cutting out bladder irritants such as artificial sweeteners and caffeine, can all help improve symptoms.

“For someone who feels like they aren’t emptying well after going to the bathroom, it may be a simple fix like standing up after urinating and sitting back down to try and empty again,” says Fairchild.

If bladder leakage is causing discomfort or distress, Kegel exercises, either at home or with a physical therapist, can help isolate the pelvic floor muscles and make them stronger, aiding in controlling urine flow. Seeing a pelvic floor physical therapist is beneficial for many women, because often even when women sense that they are performing exercises correctly, up to a quarter of them are not activating the muscles effectively.

Sessions with a therapist may involve intravaginal intervention, which involves checking that the right muscles are being squeezed at the right time. This may be especially helpful to a woman who has just given birth.

More invasive measures include options like Botox injections which treat urgency incontinence or a sling procedure aimed at treating stress urinary incontinence. Botox, which has been used for urinary incontinence for over 10 years, is injected into the wall of the bladder to help it relax since spasms can also cause incontinence.

With the sling procedure, a sling is placed under the urethra to stop incontinence that occurs with increased abdominal pressure activities like jumping, running, and coughing. The technique can be done same day, using synthetic material or your own tissue that is inserted through the vaginal opening or through a small incision in the abdomen, according to Fairchild.

SEE ALSO: Is Pelvic Mesh Safe? What Patients Need to Know

If you still feel lost about living with urinary incontinence, a physician can help create a treatment plan best suited to your preferences and lifestyle.

“Remember, this is such a common condition. You’re not alone,” says Fairchild. “Make an appointment with a doctor and see what your options are. No one should put their life on hold because of urinary incontinence.”

For more information on urinary incontinence and other pelvic floor disorders, check out our livestream here.

Urinary incontinence – Illnesses & conditions

If other treatments for urinary incontinence are unsuccessful or unsuitable, surgery or other procedures may be recommended.

Before making a decision, discuss the risks and benefits with a specialist, as well as any possible alternative treatments.

If you are a woman and plan to have children, this will affect your decision, because the physical strain of pregnancy and childbirth can sometimes cause surgical treatments to fail. Therefore, you may wish to wait until you no longer want to have any more children before having surgery.

The various surgical treatments for urinary incontinence are outlined below.

Surgery and procedures for stress incontinence

Colposuspension

Colposuspension involves making an incision in your lower abdomen, lifting up the neck of your bladder, and stitching it in this lifted position. This can help prevent involuntary leaks in women with stress incontinence.

There are two types of colposuspension:

  • an open colposuspension – where surgery is carried out through a large incision
  • a laparoscopic (‘keyhole’) colposuspension – where surgery is carried out through one or more small incisions using special, small surgical instruments

Both types of colposuspension offer effective, long-term treatment for stress incontinence, although laparoscopic colposuspension needs to be carried out by an experienced laparoscopic surgeon.

Problems that can occur after colposuspension include difficulty emptying the bladder fully when going to the toilet, recurrent urinary tract infections (UTIs) and discomfort during sex.

Sling procedures

Sling procedures involve making an incision in your lower abdomen and vagina so a sling can be placed around the neck of the bladder to support it and prevent accidental urine leaks. The sling can be made of:

  • a synthetic material
  • tissue taken from another part of your body (an autologous sling)
  • tissue donated from another person (an allograft sling)
  • tissue taken from an animal (a xenograft sling), such as cow or pig tissue

In many cases, an autologous sling will be used and will be made using part of the layer of tissue that covers the abdominal muscles (rectus fascia). These slings are generally preferred because more is known about their long-term safety and effectiveness.

The most commonly reported problem associated with the use of slings is difficulty emptying the bladder fully when going to the toilet. A small number of women who have the procedure also find that they develop urge incontinence afterwards.

Urethral bulking agents

An urethral bulking agent is a substance that can be injected into the walls of the urethra in women with stress incontinence. This increases the size of the urethral walls and allows the urethra to stay closed with more force.

A number of different bulking agents are available and there is no evidence that one is more beneficial than another.

This is less invasive than other surgical treatments for stress incontinence in women as it does not usually require any incisions. Instead, the substances are normally injected through a cystoscope (thin viewing tube) inserted directly into the urethra.

However, this procedure is generally less effective than the other options available. The effectiveness of the bulking agents will also reduce with time and you may need repeated injections.

Many women experience a slight burning sensation or bleeding when they pass urine for a short period after the bulking agents are injected.

Artificial urinary sphincter

The urinary sphincter is a ring of muscle that stays closed to prevent urine flowing from the bladder into your urethra. In some cases, it may be suggested that you have an artificial urinary sphincter fitted to relieve your incontinence.

This tends to be used more often as a treatment for men with stress incontinence and is only rarely used in women.

An artificial sphincter consists of three parts:

  • a circular cuff that is placed around the urethra – this can be filled with fluid when necessary to compress the urethra and prevent urine passing through it
  • a small pump placed in the scrotum (when used in men) that contains the mechanism for controlling the flow of fluid to and from the cuff
  • a small fluid-filled reservoir in the abdomen – the fluid passes between this reservoir and the cuff as the device is activated and de-activated

The procedure to fit an artificial urinary sphincter often causes short-term bleeding and a burning sensation when you pass urine. In the long-term, it is not uncommon for the device to eventually stop working, in which case further surgery may be needed to remove it.

Surgery and procedures for urge incontinence

Botulinum toxin A injections

Botulinum toxin A (Botox) can be injected into the sides of your bladder to treat urge incontinence and overactive bladder syndrome (OAB).

This medication can sometimes help relieve these problems by relaxing your bladder. This effect can last for several months and the injections can be repeated if they help.

Although the symptoms of incontinence may improve after the injections, you may find it difficult to fully empty your bladder. If this happens, you will need to be taught how to insert a catheter (a thin, flexible tube) into your urethra to drain the urine from your bladder.

Botulinum toxin A is not currently licensed to treat urge incontinence or OAB, so you should be made aware of any risks before deciding to have the treatment. The long-term effects of this treatment are not yet known.

Sacral nerve stimulation

The sacral nerves are located at the bottom of your back. They carry signals from your brain to some of the muscles used when you go to the toilet, such as the detrusor muscle that surrounds the bladder.

If your urge incontinence is the result of your detrusor muscle contracting too often, sacral nerve stimulation – also known as sacral neuromodulation – may be recommended.

During this operation, a device is inserted near one of your sacral nerves, usually in one of your buttocks. An electrical current is sent from this device into the sacral nerve. This should improve the way signals are sent between your brain and your detrusor muscles, and so reduce your urges to urinate.

Sacral nerve stimulation can be painful and uncomfortable, but some people report a substantial improvement in their symptoms or the end of their incontinence completely.

Posterior tibial nerve stimulation

Your posterior tibial nerve runs down your leg to your ankle. It contains nerve fibres that start from the same place as nerves that run to your bladder and pelvic floor. It is thought that stimulating the tibial nerve will affect these other nerves and help control bladder symptoms, such as the urge to pass urine.

During the procedure, a very thin needle is inserted through the skin of your ankle and a mild electric current is sent through it, causing a tingling feeling and causing your foot to move. You may need 12 sessions of stimulation, each lasting around half an hour, one week apart.

Some studies have shown that this treatment can offer relief from OAB and urge incontinence for some people, although there is not yet enough evidence to recommend tibial nerve stimulation as a routine treatment.

Tibial nerve stimulation is only recommended in a few cases where urge incontinence has not improved with medication and you don’t want to have botulinum toxin A injections or sacral nerve stimulation.

Augmentation cystoplasty

In rare cases, a procedure known as augmentation cystoplasty may be recommended to treat urge incontinence.

This procedure involves making your bladder bigger by adding a piece of tissue from your intestine (part of the digestive system) into the bladder wall.

After the procedure, you may not be able to pass urine normally and you may need to use a catheter. Due to this, augmentation cystoplasty will only be considered if you are willing to use a catheter.

The difficulties passing urine can also mean that people who have augmentation cystoplasty can experience recurrent urinary tract infections.

Urinary diversion

Urinary diversion is a procedure where the ureters (the tubes that lead from your kidneys to your bladder) are redirected to the outside of your body. The urine is then collected directly without it flowing into your bladder.

Urinary diversion should only be carried out if other treatments have been unsuccessful or are not suitable.

Urinary diversion can cause a number of complications, such as a bladder infection, and sometimes further surgery is needed to correct any problems that occur.

Catheterisation for overflow incontinence

Clean intermittent catheterisation

Clean intermittent catheterisation (CIC) is a technique that can be used to empty the bladder at regular intervals and so reduce overflow incontinence (also known as chronic urinary retention).

A continence adviser will teach you how to place a catheter through your urethra and into the bladder. Your urine will flow out of your bladder, through the catheter and into the toilet.

Using a catheter can feel a bit painful or uncomfortable at first, but any discomfort should subside over time.

How often CIC will need to be carried out will depend on your individual circumstances. For example, you may only need CIC once a day, or you may need to use the technique several times a day.

Regular use of a catheter increases the risk of developing UTIs.

Indwelling catheterisation

If using a catheter every now and then is not enough to treat your overflow incontinence, you can have an indwelling catheter fitted instead. This is a catheter inserted in the same way as for CIC, but left in place. A bag is attached to the end of the catheter to collect the urine.

Is urine incontinence normal for women?

Urine incontinence, or the involuntary leakage of urine, is a common symptom that affects 1 in 4 women. Prevalence of this problem increases with age, as up to 75 percent of women above age 65 report urine leakage. A woman’s physical, social and psychological well-being is adversely impacted. Quality of life at home and in the workplace may deteriorate.

Despite being a common problem, only 45 percent of women who experience weekly urine incontinence episodes discuss the problem with their providers. Some women may find it too embarrassing to discuss symptoms, while others may think it is normal for them to experience incontinence after childbirth or with aging.

Urine incontinence is not a singular issue; rather, it is caused by several factors. A myriad of factors often coexist, and increase the severity of symptoms and complexity of treatment.

The two most common types of urine incontinence are stress incontinence and urge incontinence. A combination of both also can occur and is called mixed incontinence.

STRESS INCONTINENCE

Stress incontinence is involuntary urine leakage in relationship to physical activities, such as coughing, laughing, sneezing, jumping or even walking. The term “stress” is used to define this type of incontinence because the stress exerted on the bladder and bladder neck by increased abdominal pressure results in failure of the weakened continence mechanisms and causes urine leakage. Women with this type of incontinence tend to disengage from favorite sports or recreational activities and try to adapt to a less-active lifestyle.

TREATMENT OPTIONS FOR STRESS INCONTINENCE

Women with stress incontinence issues most often will first be referred to a physical therapist who specializes in women’s health. The therapist will coach on how to conduct Kegel exercises to strengthen pelvic floor muscles to work more effectively and efficiently. Should that strategy fail to improve symptoms after six months, the next step is to consider other treatment options.

Other nonsurgical treatments include an intravaginal pessary. A pessary is a silicone-based device that is fitted to the vagina and inserted by a provider in the clinic. Different types of pessaries are used for different pelvic floor problems, such as urine incontinence and uterovaginal prolapse, with different shapes and sizes to fulfill the function and maintain patient comfort. The knob present in incontinence ring pessaries exert external pressure on the urethra to overcome the stress pressure imposed by daily activities. The therapeutic effect is immediate and reversible upon removal of the device.

Surgical options are available when other therapies fail. The most commonly utilized surgical procedure with a high success rate is the midurethral sling. The sling procedure utilizes a synthetic mesh material that is positioned to replace the damaged fibromuscular sling support under the midsegment of the urethra and re-establishes the continence mechanism. The procedure carries an 85 to 95 percent success rate with mesh complications reported at 3 percent. The sling procedure is considered minor surgery. Patients often are discharged home the same day with minor limitations.

URGE INCONTINENCE

Even though stress incontinence is distressing, urge incontinence usually elicits higher distress scores to women who experience it. Urge incontinence is defined as the compelling sudden urge to void that cannot be delayed or postponed and results in urine leakage. This type of incontinence does impose more restrictions on a woman’s lifestyle. Women tend to practice toilet mapping strategies, and limit outings and social activities because of the fear of social embarrassment.

This type of incontinence usually is caused by the inability of the bladder to allow pressure-free storage of urine under normal bladder capacity. The bladder tends to contract and increase pressure that results in the strong urge to void and often is associated with urine loss. Risk factors for this dysfunctional neuronal functionality usually are related to neuropathy, such as diabetes or multiple sclerosis, menopausal symptoms or some type of brain injury that alters the bladder inhibitory pathways.

TREATMENT OPTIONS FOR URGE INCONTINENCE

Treatments for this type of condition also should address the underlying cause, such as better diabetic control; weight loss; or altering the lifestyle with limitation of bladder irritants, such as caffeine and carbonated beverages.

Medications that relax bladder muscles are commonly used as first-line therapeutic options. The most commonly reported side effects include dry mouth, constipation and low blood pressure. Recently, bladder muscle Botox injections are being used in patients who have severe symptoms. Injections offer reasonable improvements in symptoms for six months with common side effects being related to urine retention or frequent urinary tract infections.

Sacral nerve root modulation — the surgical implantation of a device that helps modulate the neuronal circuitry to render the bladder more receptive to urine with decreased urgency symptoms — is a viable option for women with severe symptoms, especially those who do not respond to conventional first- and second-line treatments.

Although urine incontinence is common, it is not normal. Therefore, appropriate evaluation is necessary to determine the type and cause of this problem. Treatment options are available to help women optimize quality of life. Discussing the issue with a health care provider is the first and most important step to consider.

Tarek Khalife, M.D., is an OB-GYN in Mankato, Minnesota.



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90,000 Uroflowmetry at the Childhood Plus family clinic in Zelenograd

Uroflowmetry is a non-invasive and highly accurate method for diagnosing latent urination disorders in children and adults!

Violation of urination is the most common manifestation of urological pathology. Violation of urination is understood as a symptom complex, including a change in the frequency of urination, incontinence or urinary retention, painful urination, and urgency.Acquired diseases of the genitourinary system, such as urethritis, prostatitis, and prostatic hyperplasia, can become the reason for the gradual impairment of the patency of the urethra and the formation of obstructive urination with incomplete emptying of the bladder (residual urine). Another reason for obstructive urination is a violation of the blood supply to the bladder, which leads to a decrease in its contractility (the ability to quickly and completely empty it).

This is proved by the fact that 20 years ago 80% of men with benign prostatic hyperplasia were operated on, then the last 5 years the same 80% of patients with urination disorders are treated conservatively.The possibility and effectiveness of conservative therapy is determined by only one condition for the early diagnosis of urinary disorders.

When you start noticing episodes of delayed onset of urination, thinning of the stream of urine, a decrease in its pressure, an increase in the duration of urination, intermittent urination, a feeling of incomplete emptying of the bladder, frequent small portions of day and night urination are symptoms of severe urinary disorders and are heralds of the threat of acute retention urine.

We cannot determine the latent and initial stages of urination disorders with you, they require a special method of urodynamic examination – UROFLOWMETRY.
Uroflowmetry is the only non-contact method in medicine for assessing the functional state of an organ. Moreover, the UFM does not deliver any difficulties and inconveniences for the patient: all that is required is to fill the bladder before starting the examination, to urinate into a special funnel connected to a high-precision measuring device and a recorder.As early as 3 … 4 minutes after the examination, the patient receives a tape with a graphic representation of the urination curve. In this case, the device itself automatically calculates the most important characteristics. Analyzing the results obtained, the urologist may suspect that the patient has certain syndromes of diseases of the urinary and reproductive system, and recommend a more in-depth examination.
Then it is necessary to determine the residual urine using an ultrasound examination of the bladder. The need to determine the residual urine in the bladder is due to the fact that with a decrease in the maximum flow rate without residual urine, this condition characterizes a mild degree of urination disorders, and in the presence of residual urine, it is more severe!
After the examination, you will receive the result of the urodynamic examination printed on a paper tape with a graphic image of the urination process, indicators of the maximum flow rate and the volume of emptying of the bladder.
For the first time in practical urology in our clinic, based on the results of the examination, you yourself will objectively assess your urination by marking the intersection point of the maximum urine flow rate with the volume of emptying the bladder on the nomogram presented to you.
The nomogram statistically reliably shows the dependence of the maximum urine flow rate on the volume of emptying of the bladder, age and gender (boys, men under 50, men over 50, girls, women).In addition, the nomogram shows three main zones for assessing the nature of urination: green – the zone of normal urination, yellow – the zone of obstructive urination, and red – the zone of critical urination.

For girls and women, the 4th white is marked – the zone of rapid urination.

However, the state of urination does not always depend on age, since most adult diseases are diseases that are missed and untreated in childhood, therefore diagnosis of latent forms of urination disorders in children and their timely treatment determines their quality of life when they become adults.
Uroflowmetry – a screening study, that is, it is carried out for all children and adults, regardless of whether they have a complaint or not. At the same time, if you have complaints regardless of the result of primary uroflowmetry, then you need to repeat uroflowmetry in order to exclude or confirm the presence of urination disorders in 99.9%.
Men who have uroflowmetry in the green zone and have no complaints should follow the recommendation of the American and European Association of Urology , which states: men over 40 years of age should have uroflowmetric monitoring of urination every year, even if there are no complaints.
It should be noted that uroflowmetry is the only non-invasive method of objectively assessing the effectiveness of your treatment. With effective treatment, you will see, according to the results of control uroflowmetry, how your indicators will move from the red-yellow zones to the green zone of normal urination.

In the family clinic “Childhood Plus” UROFLOOMETRY is carried out by appointment ( Monday, Saturday 15.00 – 20.00 ). The study is performed on a Canadian uroflowmeter.

Treatment of urinary incontinence in young women with coughing and laughing

… – Well, in your case, the operation will help the best.
– Operation?
– Yes. It is necessary to create support for the urethra so that it does not open when coughing, so that it has support. Here, look, – I draw a diagram and the result of the operation, – a special thin mesh is installed under the urethra, which limits the opening of the urethra. And the incontinence stops.
– And she won’t squeeze the canal so that I can’t urinate at all? “The patient’s eyes are horrified by my drawings.
– No, – I smile, – if we translate the name of the operation TVT-O – Tension free Vaginal Tape – Obturatorius, we get a “tension-free vaginal loop, passed through the obturator opening.” This means that the mesh itself does not press on the urethra, but only serves as an emphasis for it, support.
– How long do you need to stay in the hospital? How long will it take for everything to heal? Will it hurt for a long time?
– One day.
Doesn’t believe. Facial expression – like Stanislavsky’s – I don’t believe it, and that’s it.
– Hmm … Look, Vera Petrovna. With this operation, the incision is only one centimeter. Why be sick there? What is there to recover? And, most importantly, why lie for a long time?
– What about anesthesia? But how to come to your senses?
– Anesthesia … Spinal anesthesia or intravenous anesthesia for 30 minutes. As soon as I finish the operation, you will wake up right away – I am telling you about safe anesthesia.
– Okay, – she suddenly decides, – what are my actions? And when is the operation?
– You pass a preoperative complex of analyzes, consult a therapist and anesthesiologist.And by the end of the week, I’ll operate on you. On Friday – the operation, after the operation I lift you to your feet, on Saturday already – home, on Monday – to work …
– Doctor, can I even lie down a little during the operation? – The smile changes her face beyond recognition.
P.S. A year has passed.
A pretty woman comes into the office with a child of about four years old. She smiles.
– Hello Doctor.
– Good afternoon, come in, please, sit down, – I myself wash my hands with an antiseptic, very smelly, I sit down.
– Do you recognize, doctor? – The woman smiles even more broadly. – You operated on me a year ago.
I am trying to remember, I stare into the face. At this moment, the child mischievously sniffs at my hands, wrinkles his face, and loudly declares: “Ugh! Smells! ”

90,000 For what symptoms is it necessary to go to the urologist and is it possible to self-medicate?

To begin with, it is better not to wait for the onset of symptoms (manifestations of the disease). When symptoms appear, it may not be too late to see a urologist, but at least the disease may already be developing.It is better to regularly conduct preventive examinations and do an ultrasound scan, and then, perhaps, no symptoms will bother you and will not occur at all. We will talk about this today with the candidate of medical sciences, leading oncourologist of GMS Hospital Maxim Khokhlov.

The three classic, most common and threatening symptoms (manifestations of the disease) in urology are pain, blood in the urine and urinary disorders (difficult, rapid, nocturnal, etc.).etc.). Very often in urology, you can find a combination of the entire triad of symptoms, as well as including other manifestations.

Pain

The pain can be of a different nature and have different localization. As a rule, we take acute pain more seriously, forcing us to seek help from a doctor as soon as possible. At the same time, you can endure a dull, aching pain, and continue not to pay special attention to it until something happens. This is fundamentally the wrong approach! Such pain can also be a manifestation of a serious illness, so it is better to go to the doctor anyway and get tested.

Based on the localization of pain, you can navigate in relation to the organ that is most likely unhealthy now. So, pain in the lumbar region can talk about kidney problems, pain in the lower abdomen, in the perineum – about diseases of the bladder, prostate gland, male genital organs. Especially you need to pay attention to pain combined with fever and chills – these are, as a rule, symptoms of rapidly developing diseases, such as urolithiasis, cystitis, pyelonephritis, etc.

Pain is often the only symptom of cancer, and sometimes the first manifestation. Although a lot of urological oncological diseases develop without symptoms, that is, for a long time, a person is absolutely not worried about anything, and already at the later stages we note the appearance of pain in patients of one or another localization.

Admixture of blood in urine

The appearance of an impurity of blood in the urine is gross hematuria. There are two types of hematuria – macro and micro.

  • Macrohematuria is when we can see with our eyes the changes in urine, it can change from pale pink to intense maroon-red color, there may be blood clots, according to the structure of which the source of bleeding can be indirectly assumed.
  • Microhematuria is when we can determine the amount of blood in the urine only microscopically by analyzing the urine sediment.

In this case, you also need to be on your guard, because these can also be symptoms of both tumor and inflammatory-destructive lesions of the organs of the genitourinary system (kidneys, ureters, bladder, prostate, urethra).

Urinary Disorders

Another rather serious symptom is urination disorder. For example, it can become more frequent, accompanied by pain, cramps, frequent urge to urinate, sometimes so uncontrollable that a person must go to the toilet, because if this does not happen, then there is a risk of not holding urine.

Such symptoms, as a rule, characterize an inflammatory disease of the male or female sphere.In a man, as a rule, these are symptoms of pathological changes in the prostate gland or urethra. In women, this is usually a symptom of bladder inflammation (acute or chronic).

Difficulty urinating is most often a man’s lot, it is a symptom that often occurs with the development of benign prostatic hyperplasia, the so-called adenoma. When the gland grows, squeezing the urethra, and does not allow urination, as it did in a man at a younger age.This is also a rather serious symptom, and it can be noted in case of cancer of the prostate gland, therefore, it is imperative to visit a urologist regularly, especially for men after 45-50 years, because the risk of developing prostate diseases at this age increases.

Sometimes urination disorders are the result of neurological disorders of a different nature, and here it is important to try to recognize their nature and involve a related specialist to help the patient.

Self-medication – is it good or not?

Another most frequently asked question: “Is it possible to self-medicate?” Here it must be said that it does not matter in which discipline it is about self-medication – oncology, urology, gynecology, therapy, I would categorically not recommend self-medication. It should be noted that even we, doctors, in rather difficult and difficult situations, do not put our signature and do not make a decision alone.As a rule, we collect specialized consultations, which consist of several specialists, in order to deal with a specific patient as much as possible, because our ultimate goal is to help the patient as efficiently as possible. Therefore, do not hesitate to spend a little more time on your health by contacting a qualified doctor.

My opinion is that it is categorically impossible to self-medicate. There are, of course, some exceptions: herbal preparations, fees, dietary supplements, which at least will not bring much harm to the patient in case of self-administration.

The first reason why I would not recommend treating yourself is that any symptomatology (that is, the manifestation of the disease) can be lubricated with the wrong treatment of the disease. The clinical picture will be disturbed, this will complicate further diagnosis and, accordingly, the correct diagnosis and the correct treatment for the patient. And it will be difficult for the doctor to determine how the disease proceeded and to prescribe treatment, which ultimately will negatively affect the patient.

The second, rather important reason is the formation of antibiotic resistance (resistance of microbes to antibiotics). Very often, self-administration of antibiotic therapy recently, “on the advice of a friend” or a pharmacist in a pharmacy, who now often do not have a medical education, leads to improper treatment and to the formation of bacterial resistance to subsequent treatment.

A certain microbe is affected by a certain medicine.Not knowing the pathogen that caused your disease, simply by prescribing an antibiotic in your opinion, we risk not only not curing the disease and lubricating all the symptoms of this disease, but also getting the flora resistance to these and other antibiotics in the future.

Self-medication is especially dangerous in cancer patients. I very often had to meet with patients who, for one reason or another, refused orthodox medical care and resorted to various paramedical advice, treatment, etc.And as a result, these patients come later with advanced stages of the disease, with metastases, often at a time when it is no longer possible to help them radically. It remained only to prescribe them an auxiliary, symptomatic treatment in order to prolong life and somehow improve its quality. I consider this situation to be extremely incorrect and dangerous for the patient.

I want to note that sometimes prescribing antibacterial drugs on their own can have fatal consequences for the patient.

Such a condition is known as bacteriotoxic shock – this is when, for example, with pyelonephritis, which develops in a kidney blocked by a stone, urine does not outflow, we prescribe an antibiotic, it destroys bacteria from which endotoxin is released during destruction, but since the outflow of urine from the kidney is blocked stone, there is a lightning-fast absorption of this endotoxin into the blood. Mortality from this condition is very high, resuscitation measures are often untimely, because this is a very rapidly developing complication.Therefore, with self-treatment, the patient may not even have time to be hospitalized in a hospital, where he could be provided with qualified assistance.

It would seem that at first glance, harmless self-medication can lead to fatal consequences for the patient. Self-medication is a completely wrong tactic that patients should not use in the context of the development of modern medicine.

How does incontinence manifest in Alzheimer’s

“The scourge of the XXI century” – this is how Alzheimer’s disease is now called.This form of dementia is one of the most common chronic diseases in the elderly. Usually, its manifestations become noticeable after the age of 65, although there are many cases of an earlier onset of the disease. A person with such a diagnosis gradually loses simple and necessary skills for self-care, and his loved ones have to take on all the responsibilities of caring for him.

How does Alzheimer’s disease develop

The timing of the development of the disease is individual for everyone.More often it makes itself felt in old age, and its initial manifestations may not be taken into account due to the concomitant symptoms of other chronic diseases (hypertension, vascular atherosclerosis, and much more). Manifestations that can signal the onset of Alzheimer’s disease include:

90 095 90 096 concentration disorders;

90,096 difficulties in assimilating and memorizing new information;

90,096 forgetfulness.

All these symptoms can be easily attributed to regular age-appropriate changes.Unfortunately, there is no simple diagnostic test for Alzheimer’s disease yet. Therefore, the diagnosis is established on the basis of a survey of the patient and his relatives, complaints and the results of a comprehensive examination.

How fast is the disease progressing?

The rate at which the disease progresses can vary greatly. For example, in some patients, cognitive functions deteriorate rapidly and after a couple of years after the initial symptoms, there are grounds for receiving the first group of disability, since the person completely loses the ability to self-care and needs constant care.

In other cases, the process is very slow, and it takes up to 20 years for the disease to progress to a severe stage. But the average life expectancy for people with Alzheimer’s disease is still 3 to 9 years from the time of diagnosis.

The danger of Alzheimer’s disease is that, despite treatment, there is a gradual loss of the ability to perform simple everyday tasks. A person periodically does not recognize close relatives, sometimes he can get lost in his own apartment or leave the house and not remember the way back.In severe dementia, loss of speech, problems with maintaining balance, and loss of motor skills (partially or completely) develop.

Unfortunately, loss of control over urination and bowel movements is almost inevitable, especially in the later stages of the disease. In this case, caring for the patient, which already takes a lot of mental and physical strength, becomes even more time consuming.

How does incontinence manifest in the middle stages of the disease

Difficulties with urination control in the early and middle stages of the disease are manifested mainly against the background of existing diseases of the urinary tract, which is not uncommon in the elderly.Therefore, the occurrence of incontinence should not be immediately attributed to the symptoms of Alzheimer’s disease – it is necessary to undergo a comprehensive examination, starting with a visit to the urologist (if there are no other complaints). For example, incontinence can be triggered by inflammation of the urinary tract, which is easily treatable.

A person with moderate severity of Alzheimer’s disease may occasionally experience “interruptions” in urination control due to limited mobility. A person simply does not have time to reach the toilet in time or forgets where it is located.

In such cases, taking preventive measures will help:

  • hang in a conspicuous place a schedule indicating the time of mandatory trips to the toilet or by other means to provide the patient with a periodic reminder of the need to visit the sanitary room;
  • Do not lock the toilet door, leave the light on in it;
  • choose underwear for the patient that can be easily removed and put on;
  • Use absorbent hygiene products.

For such situations, pant diapers are suitable, which quickly absorb liquid, turning it into a gel that is securely stored inside. Pant diapers block the spread of unpleasant odors, prevent leaks, protect the skin from the appearance of diaper rash, keeping it dry. Correctly selected absorbent products improve the patient’s quality of life and positively affect his psychological state, as well as facilitate his care.

With memory impairment against the background of the middle stage of dementia, the brain can maintain control over the process of urination, but the patient goes to the toilet in places that are not intended for this.In Alzheimer’s disease, it is useless to try to change something by scolding or conducting educational conversations with the person. In this case, the situation can be corrected with the help of diapers for adults, worn under difficult-to-remove clothing, in order to prevent the patient from taking off the diaper on his own.

High-quality absorbent hygiene products significantly facilitate patient care by keeping the skin dry and protecting against irritation. And it is much easier to periodically replace such products (panties or diapers) than to deal with the consequences of a patient’s loss of orientation when going to the toilet.

What to do with advanced Alzheimer’s incontinence

The late stage of the disease is manifested by severe dementia, when a person loses the ability to take care of themselves and loses even simple everyday skills. In this case, urinary incontinence becomes an ongoing problem. In addition, the patient’s mobility deteriorates sharply.

Diapers for adults can provide comfort for patients with incontinence and limited mobility by absorbing and stably holding large volumes of liquid and preventing the spread of unpleasant odors.The correct selection of absorbent products in terms of size and quality, as well as their combination with the necessary moisturizers and sanitary napkins for the skin, can reduce the risk of bedsores, diaper rash and dermatitis.

Use of adult diapers for Alzheimer’s

To cope with the consequences of severe incontinence, the iD SLIP adult diapers, designed specifically for bedridden patients and for people with severe mobility limitations, will help.In the line of absorbent products, there are diapers of different sizes, which can be easily determined by knowing the patient’s waist. Their multi-layer absorbent layer reliably holds large volumes of liquid and prevents unpleasant odors from spreading.

The design of adult diapers includes reusable Velcro fasteners to adjust the fit of the product, side barriers to prevent leaks, and an elastic waistband for a snug fit. The perfect fit of the diaper to the back is of particular importance for patients who are lying down for a long time, as they have an increased risk of fluid leakage.

The moisture saturation indicator helps to easily control the filling of the product and change it in time. The diapers, thanks to the breathable materials and flat seams, do not cause discomfort in the patient, do not irritate the skin, which is confirmed by the results of dermatological tests.

Difficulty urinating – delay, disorder or lack of urination

Difficulty urinating is one of the most common complaints among women who visit urologists [1] .Usually they complain of pain and cramps when urinating, but besides this, there are problems with a weak and intermittent stream during urination, frequent and nocturnal urge to urinate, incontinence and urinary leakage, etc.

This can be a long absence of urination if you want to urinate, the release of urine in a weak stream or drop by drop, a prolonged or intermittent act of urination, accompanied by painful sensations in the process. It is usually impossible to immediately identify why the disorder has arisen.

Undoubtedly, this greatly affects the quality of life of women and impairs their socialization. These conditions cannot be left untreated. And in order to prescribe competent therapy, you need to figure out what can cause these pathological conditions.

The bladder, its sphincters and the urethra work in a single ligament. Their function: the accumulation of urine in the bladder and its emptying. The elastic bladder walls allow urine to be collected from the ureters by gently stretching, controlling the tension of the muscular membranes of the bladder (detrusor).

When emptying, the detrusor muscles tense, the urethral sphincter and pelvic floor muscles relax. If the coordination of these processes is violated, the patient has problems with urination.

They are subdivided into accumulation syndromes (urinary incontinence, nocturnal diuresis, frequent urination), emptying syndromes (weak stream of urine, difficulty, intermittent urination, urinary retention, urination with straining), postmictional syndromes (urinary leakage, feeling of incomplete emptying) [ .

Difficulty urinating is a condition that occurs in a variety of urological and neurological diseases.

Cystitis

Acute cystitis is the most common urological pathology among women. Due to the anatomical features of the female urethra (proximity of the vagina and rectum, short length and large width, facilitating the penetration of infection into the bladder), virulence of the pathogen, violation of personal hygiene rules, a decrease in the local immune response, concomitant diseases and other reasons, acute cystitis often takes chronic recurrent form [3] .

In chronic cystitis, an overactive bladder may develop with a decrease in its capacity and an increase in pressure inside, as well as increased activity of the muscle that compresses the bladder. All these pathological changes can lead to frequent urge, spasms and pain when urinating [2] .

Surgical and diagnostic interventions

Pain, cramps, weak or intermittent stream, urge to urinate may be the result of surgical intervention on the pelvic organs and kidneys, the consequences of cystoscopy [4] .

Pregnancy

The growing uterus puts pressure on the organs of the urinary system, making it difficult to pass urine. This condition cannot be considered a pathology, however, it can also bring a lot of inconvenience. Difficulty in the outflow of urine during pregnancy can be a predisposing factor for the development of urolithiasis, the formation of stones in the bladder, and the development of pyelonephritis.

Kidney and bladder stones

The growth of stones in the renal pelvis and bladder stones can become a mechanical obstacle to the outflow of urine.Usually, the urine becomes cloudy at the same time, with the movement of stones – with impurities of blood. And violations of urination are accompanied by severe pain in the lumbar region and fever.

Postmenopausal changes

Urinary disorders in women during menopause are associated with estrogen deficiency, which leads to atrophic changes in the mucous membranes, weakening of the musculo-ligamentous apparatus of the small pelvis, which causes prolapse of organs, disruption of blood supply in the vascular plexuses of the urethra.This leads to urinary incontinence, leakage, increased nocturnal urine output, involuntary contractions of the bladder muscles, and an overactive bladder [5] .

Overactive bladder

This is a fairly common cause of urinary disorders among women and men [6] . With this pathology, involuntary activity of the muscular membrane of the bladder is observed when it is filled. This causes a frequent urge to urinate, the excretion of urine occurs in small portions, with pain.The jet can be intermittent, weak.

An overactive bladder can have neurogenic causes (Parkinson’s disease, multiple sclerosis, Alzheimer’s disease, organic brain damage) and be considered as an independent disease associated with a violation of the innervation of the bladder. To make this diagnosis, a number of other diseases must be excluded [3] .

Hyporeflex bladder

With a decrease in the sensitivity of the bladder and overstretching, a condition can be observed that is called a hyporeflex bladder.In this condition, the patient is forced to urinate in a thin, sluggish stream, press on his stomach, thus helping to empty the bladder. There is a chronic urinary retention, which is dangerous for the development of an infection in the urinary tract, the spread of this infection to the kidneys ascending, the formation of stones in the bladder, the development of renal failure, up to a complete loss of kidney function. This is already a life-threatening condition.

Urethral stricture

Narrowing of the urethra in women can occur as a consequence of trauma to the pelvic organs, inflammatory diseases, the appearance of adhesions between the urethra and the vagina, etc.Depending on the severity of the stricture, urine may leak in a weak stream or intermittently.

Injuries and tumors of the spine, brain

Disorders of urine outflow in trauma and neoplasms of the central nervous system are associated with innervation of the bladder, urethra and pelvic muscles, which leads to discoordination of the act of urination. This condition is called neurogenic bladder and is most often manifested by difficulty urinating (in 64%) [7] .

More rare causes are:

  • clots of blood or mucus in the urinary tract,
  • ingestion of foreign objects into the urinary tract.

Due to the variety of causes of the disorder itself, the first step in treatment is to identify the causes. To do this, you need to contact a therapist, urologist, nephrologist, who will be able to prescribe an examination plan and treatment tactics.

For diagnostics, cystoscopy, urofluometry, ultrasound of the pelvic organs and kidneys, a comprehensive urodynamic study (CUDI) are used, a general urine test, bacterial urine culture, urine tests according to Zimnitsky and Nechiporenko, tests for sexually transmitted diseases are performed.

Further tactics depend on the diagnosis. For example, if you have a urinary tract infection, you should start by eliminating it: antibacterial drugs are prescribed. If the difficulty in urinating is caused by the presence of stones, neoplasms, or the ingress of foreign objects into the body, their surgical removal becomes the most important measure.

Postmenopausal changes are treated in conjunction with gynecologists, if necessary involving surgeons to eliminate the prolapse of the pelvic organs.

Often the occurrence of an overactive and hypoactive bladder can be associated with diabetes mellitus. In this case, the forces of endocrinologists [8] are involved in the treatment.

You need to understand that trying to heal yourself is a bad idea. For example, if the cause of urinary retention is a tumor or stones, the lack of timely medical attention can be critically dangerous to health and life. In the most severe cases, a catheter or suprapubic drainage called a cystostomy is used to drain urine.

Sometimes lifestyle adjustments are enough to cope with the disorder. Retention and absence of urination can often be triggered by excessive consumption of alcohol or caffeinated beverages, improper diet, certain medications (including diuretics), and interactions with a number of chemicals.

Also recommended:

  • adequate drinking regimen,
  • 90 096 timely visit to the toilet,

  • personal hygiene: change of pads, linen, washing,
  • treatment of infectious diseases of the pelvic organs,
  • 90 096 adherence to a diet with a tendency to form kidney stones, etc.

As a rule, with a competent approach, soon enough it is possible to find out what caused the violation of urination, and cope with its manifestations. However, only a specialist can do this.

Viral hepatitis – what you need to know?

Viral hepatitis (A, B, E, C, D)

Viral hepatitis is not a very pleasant family of at least five viral hepatitis (A, B, E, C, D). They are responsible for five different diseases.

Viral hepatitis A

Viral hepatitis A is called fecal-oral, or, more simply, the disease of unwashed hands. Viral hepatitis A is more common than all other members of the hepatitis clan. First of all, preschool children get sick with viral hepatitis A, having tasted unwashed fruits, grabbing a sandwich with dirty hands, licking a toy or their own fingers. Viral hepatitis A does not produce severe and chronic forms. The patient’s temperature rises, weakness, fatigue, vomiting are observed, and after a week he becomes like a huge mimosa.As soon as the child turns yellow, he is already non-contagious and will recover in a couple of weeks, having said goodbye to viral hepatitis A forever. Many doctors believe that for this disease it is better to be treated at home, and not in a hospital. The main thing is good care, proper nutrition, cheerful mood. And best of all, mom organizes it.

Prevention of viral hepatitis A

Dear mothers, the best prevention of viral hepatitis A for all time: do not forget “fragrant soap and fluffy towel.”It is in your power to make sure that your beloved child soap hands before eating, have an afternoon snack only with well-washed fruits. If someone in the family has hepatitis, treat his things, toys, dishes with chloramine. Viral hepatitis A is much less common in adults. But this also happens. Remember this when going on a trip, first of all, to Asian countries. There you just need to start the day with reading “Moidodyr”, because this children’s book describes in detail all the necessary hygiene requirements that will save you from illness.

Viral hepatitis E

Viral hepatitis E by the mode of transmission is similar to viral hepatitis A. In Moscow and the middle lane, viral hepatitis E is very rare. Basically it is “brought” from Central Asia. There, this infection is recorded annually. Infection with viral hepatitis E can theoretically occur through household contact, but most often through water, when fecal runoff gets into it during floods or mountain avalanches. An epidemic is usually like an explosion.Mostly affects people of blooming age – from 15 to 30 years. Experts are confident that the liver is the only target of the virus. Viral hepatitis E disease usually begins with nausea, loss of appetite, weakness, and jaundice appears after 4-10 days. In uncomplicated cases, recovery occurs in about a month. Men are twice as likely to be affected by the disease than women. However, viral hepatitis E is very dangerous for pregnant women: almost one in five does not survive.

Prevention of viral hepatitis E

In Central Asia, to prevent viral hepatitis E, it is best to drink only boiled water.The hepatitis E virus, remaining frozen, dies in boiling water.

Pregnant women, you are the most at risk. That is why, be as attentive as possible to the rules of personal hygiene. During an outbreak of the disease, it is best to go to relatives in another city or village. And at the first alarming symptoms, be sure to see a doctor and in no case refuse hospitalization.

Travel lovers and business travelers, information especially for you. The hepatitis E virus feels extremely at ease in the countries of Southeast Asia (especially in India, Burma and China), Africa, Central America (less often in the Asian region of the former USSR), so the above tips may also come in handy during your travels.

Viral hepatitis B

Viral hepatitis B is perhaps no less a problem of our century than AIDS. Only AIDS is rare enough, and hepatitis B is very common, and usually 20-40-year-olds get sick. It is difficult to diagnose viral hepatitis B without special laboratory tests. But a yellowed face is certainly a serious reason to see a doctor. The virus is transmitted through the blood, semen, vaginal discharge of patients. All donated blood for transfusions is tested for hepatitis B virus without fail.And this seems to be true, since no more than two out of a hundred people are infected through the blood. Unfortunately, half of the patients with viral hepatitis B are people who have been very unsuccessful in visiting the dental or gynecological office, as well as victims of “syringe hepatitis” when the infection occurred during injections with a dirty syringe. The rest usually fall ill with viral hepatitis B through sexual contact with a sick person or through everyday life: through a common toothbrush, manicure accessories, razor .. Many patients with viral hepatitis B, as well as carriers of the virus, without knowing it, safely infect others.Approximately 2% of patients with chronic low-activity hepatitis are dangerous, which they themselves, as a rule, do not even suspect. Pregnant women transmit the virus to their babies most often when they pass through the birth canal. Often it is fatal for a baby and contributes to the development of liver cancer, and more often than all other hepatitis it transforms into a chronic form, sometimes lasting for decades. Risk groups: physicians working with blood, including in intensive care units; children born to a sick mother; family members where there is a patient with hepatitis or a virus carrier; patients who often undergo surgery; drug addicts; homosexuals.

Prevention of viral hepatitis B

To prevent viral hepatitis B, never use someone else’s toothbrush, manicure set, razor! This is especially true for families where there are patients with hepatitis B. It is useful for them to know that the virus dies when clothes and linen are boiled for at least 45 minutes.

In case of accidental sexual contact, a condom will save you from contracting not only viral hepatitis B, but also a whole bunch of other diseases.

Refuse the injection if it is not done with a disposable syringe taken out in front of your eyes from a special package.

Dear ladies, you better make sure you are healthy before you get pregnant.

Dear teenagers, tattoos are in vogue, decorate yourself only in beauty salons, where all hygiene rules are observed.

Earrings – please pierce your ears, in beauty salons.

Gentlemen, travelers, you know, viral hepatitis B is one of the first places in mortality among those who have been abroad for a long time, especially in Asia, Africa, Central America.

The best way to protect yourself from viral hepatitis B is by getting vaccinated. They do not refuse her when a baby is born, even in prosperous countries, Belgium and the United States. WHO sees vaccinations as the only way to cope with hepatitis B virus infection by 2015. In our country, alas, this is unrealistic. A domestic vaccine exists, but its industrial production has not been established. There is an imported Belgian vaccine in Russia. And this is also a way out. In the first place, of course, children, then it is necessary to vaccinate medical workers, better than students, as well as the family environment of patients, all the soldiers fighting in the Caucasus and Central Asia.

Viral hepatitis D

Viral hepatitis D “goes in pairs” with hepatitis B. Viral hepatitis D, as it were, parasitizes on B. This “duet” gives rise to eight out of ten severe forms, seven out of ten cases of chronic hepatitis. Fighting viral hepatitis B, there is a chance to permanently deal with viral hepatitis D. If your loved one suffers from a severe form of viral hepatitis B, you need to insist that he be examined for the presence of markers for hepatitis D. Infection with hepatitis D and its prevention are the same. that with viral hepatitis B.

Viral hepatitis C

“Affectionate killer” – this is how experts call viral hepatitis C. In Russia, this disease has been diagnosed only for the last few years. But now it now and then makes itself felt in different parts of the country. Outbreaks of viral hepatitis C have been recorded in Moscow, Voronezh, St. Petersburg and other cities. Clinically, viral hepatitis C is mild, lethality is one in a hundred, but often ends in severe chronic liver diseases.Fatigue is often the main symptom. The disease can also occur with pronounced jaundice. Almost half of infections occur during blood transfusions, so the presence of hepatitis C virus in donated blood is monitored. Prevention of viral hepatitis C – remember the recommendations on how to cope with hepatitis B and D.

If your face turns yellow, see a doctor, apparently you have hepatitis or, in any case, something is wrong with your liver. Unfortunately, having been ill with one of the hepatitis, you did not get immunity to the rest.

Prevention of viral hepatitis

Viral hepatitis is an infectious inflammation of the liver caused by viruses such as A, B, C, D and others. They can be acute, chronic and subclinical, but they are always life threatening. Unlike medicinal, autoimmune and other non-infectious hepatitis, viral hepatitis is manifested not only by jaundice, an increase in the volume of the liver and its soreness, but also by headache, high fever, nausea and vomiting. You need to know that it is almost impossible to get rid of some viruses, for example, C, and all treatment measures are reduced to relieving symptoms and inhibiting the reproduction of the virus.Hepatitis viruses are transmitted mainly with human biological fluids, are highly resistant in the external environment, and can survive in water and on needles for up to two to three weeks. To avoid infection with hepatitis, it is necessary to completely cut off the chains of possible infection, since even the most persistent immunity is not able to prevent the development of the clinical picture. In addition, it must be borne in mind that hepatitis B and C are transmitted from mother to fetus. Prevention of hepatitis A. Hepatitis A is transmitted mainly by the fecal-oral route – through water, food, common items.The most effective measures to prevent infection will be:

  • Compliance with the rules of personal hygiene, washing hands before meals and after each visit to the toilet.
  • Maintaining cleanliness in the house.
  • Drinking only pure water. Hepatitis A is often acquired through drinking from unknown sources.
  • It is strictly forbidden to use uncomposted manure and droppings as fertilizer in the soil.
  • Vegetables and fruits should be washed thoroughly before use.
  • Never share with other items such as razor, scissors, towel, toothbrush.

In general, hepatitis A is very easy to get infected in the home. Therefore, if a person with such a diagnosis appears among your acquaintances, then it is better to completely exclude contacts until he recovers. Prevention of hepatitis B and C The most dangerous among all infectious hepatitis are precisely those caused by types B and C. They have not only a similar clinical picture and the need for an intensive course of treatment, but also common routes of infection.Infection occurs through the use of non-sterile medical instruments, blood transfusion, sexually and from mother to fetus, much less often hepatitis B and C are transmitted through the joint use of hygiene items – toothbrushes, towels, napkins, shavers, MANICURE KITS ..

Prevention measures include:

  • Close control of the use of syringes, boring machines and other instruments in medical institutions. After each patient, reusable equipment must be disinfected, and disposable equipment must not be reused.Of course, the risk of contracting hepatitis in a healthcare setting is low, but do not overlook the possibility of employee negligence.
  • Avoid promiscuous sex, always use a condom.
  • Drug addiction is a special diagnosis. Needless to say, drugs should not be used? If you do do this, then do not use used syringes and needles, as well as straws for inhaling cocaine – even after lying for a month, they can contain hepatitis viruses.
  • If there was a situation in which you could become infected, then take the analysis as soon as possible. Remember that early treatment is much better than late treatment, and the incubation period for hepatitis B is 120 days, C – about 150.
  • Do not share personal hygiene items with other people.

Hepatitis is transmitted from mother to fetus. However, this is not a sentence for a baby – a pregnant woman needs to see a doctor who will prescribe a course of treatment.Combined with the patient’s high discipline and personal hygiene, medication in most cases avoids contamination. Prevention of hepatitis D. The hepatitis D virus is a kind of parasite virus that cannot multiply without the type B virus. Therefore, preventive measures will be similar to the prevention of hepatitis B.

Decency, cleanliness and the absence of addictions are the best measures for the prevention of viral hepatitis.

Viral hepatitis: how not to get sick

Hepatitis, an inflammation of the liver caused by a viral infection, is one of the most common and serious infectious conditions in the world.There are five hepatitis viruses, defined as types A, B, C, D, and E. Depending on the type of hepatitis, people can become infected either from infected body fluids or from contaminated food and water.

Infection with types B, C and D occurs through the blood of an infected person, and in the case of hepatitis B and C, also through unprotected sex. Type D infects only those who already have hepatitis B. Types A and E are usually transmitted through contaminated water or food and are closely associated with inadequate sanitation and poor personal hygiene.

Acute infection may present with symptoms such as jaundice (yellowing of the skin and eyes), excessive fatigue, nausea, vomiting, and abdominal pain. Types B and C may be asymptomatic in some cases at an early stage of the disease. A significant proportion of people infected with these viruses can only learn about their illness when it becomes chronic, sometimes several decades after infection. Unaware of their infection, they can pass it on to other people.

Hepatitis infections are common throughout the world. In many countries, data on the prevalence of infection are not available; however, an estimated half a billion people are chronically infected with hepatitis B or C. It is estimated that such chronic infections account for 57% of cirrhosis and 78% of primary liver cancers. 240 million people in the world have chronic hepatitis B infection, 150 million people have chronic hepatitis C infection. Viral hepatitis is one of the eight leading causes of death in the world, with 1.4 million deaths annually.

Hepatitis B / HIV and hepatitis C / HIV coinfections are becoming a growing problem in countries with HIV epidemics and among people who inject drugs. For such patients, concomitant viral hepatitis becomes one of the main causes of death, even with timely antiretroviral treatment. Acute hepatitis B is curable, and it is estimated that 20-30% of chronic B (HBV) patients can be treated effectively. In recent years, new oral antiviral drugs have also been developed for the treatment of C infection (HCV).Vaccination is an effective way to prevent hepatitis B. In Russia, the viral hepatitis B vaccine is included in the calendar of compulsory free vaccinations. The effectiveness of this treatment has been confirmed in 95% of cases. There is currently no vaccine against hepatitis C.

Another opportunity to reduce the spread of hepatitis B and C is the elimination of injections with non-sterile equipment and the transfusion of unverified donated blood and blood products created on its basis.

About holding the Day of Health on the topic

“Keeping the liver healthy”

On July 23, 2016, the State Budgetary Healthcare Institution “Center for Medical Prevention” of the Ministry of Health of the Krasnodar Territory organizes the next Health Day, which is held within the framework of the World Hepatitis Day (July 28) under the slogan “Let’s keep the liver healthy”. Health Day is held with the aim of preventing liver diseases, promoting the principles of a healthy lifestyle.A demonstration Day of Health with the participation of regional specialists will be held in the Krasnoarmeysky District. During the Day of Health, organized jointly with the district administration and with the participation of the press, diagnostic studies, consultations, lectures, promotional and festive events will be carried out.

World Hepatitis Day is celebrated annually on 28 July. The holiday was established by WHO at the initiative of the World Alliance Against Hepatitis. In 2016, it is celebrated for the 9th time. The date is celebrated by medical workers, epidemiologists and virologists.The date of World Hepatitis Day is dedicated to the memory of the doctor Baruch Samuel Blumberg, who discovered the hepatitis B virus and studied its pathological effects on the liver.

Health is the most important wealth of every person. The quality of life mainly depends on the indicators of physical condition. Unfortunately, most serious diseases today are widespread and threaten the general well-being. This includes hepatitis. According to medical workers, the declared International Day Against Viral Hepatitis allows focusing on preventive measures, increasing the number of people vaccinated and implementing national programs to combat this disease.

Hepatitis is a viral liver disease that wreaks havoc on the entire body. A viral infection spreads easily and can cause an epidemiological case. This disease is recognized by doctors all over the world as a globally dangerous public health problem. According to WHO, viral hepatitis has already affected about 2 billion people, that is, every third inhabitant of the Earth. Someone has already been ill, and someone is a carrier of pathology.

In the Russian Federation, on the basis of a government decree in 2014, hepatitis was included in the list of socially dangerous diseases.According to rough estimates, in 2015 in Russia, about 2.5% of the population are sick or infected with severe liver disease.

Effective preventive measures against disease are hygiene, attentiveness during blood transfusion and caution when choosing sexual partners. The main protection against hepatitis of viral etiology is vaccination. In Russia, the vaccine against viral hepatitis B is included in the calendar of compulsory free vaccinations. Of considerable importance in prevention is the dissemination of information about the pathways of the disease, the need for immunization, compliance with hygiene rules and the passage of medical examination.

The World Hepatitis Day is aimed, first of all, at drawing the attention of the general public and specialists to this problem, increasing the interest of citizens of each country in carrying out preventive measures. The use of hygienic knowledge in practice by each person, recognition of the importance of immunization of hepatitis A and B, as well as participation in vaccination campaigns will help preserve the health of the population not only of each individual country, but also of the world’s population as a whole.

GBUZ “Center for Medical Prevention” of the Ministry of Health of the Krasnodar Territory.