Urgent urinary incontinence
Urinary incontinence is an intolerable urge to urinate that cannot be contained by an effort of will. This is also called urinary incontinence. Its cause lies in an overactive bladder.
Normally, the urge to urinate occurs after a sufficient amount of urine accumulates in the organ cavity. Feeling this urge, the person goes to the restroom, where he empties the bladder. When the reactivity of the bladder is increased, even a small amount of urine is enough for a woman to have an intolerable urge to urinate. In the event that there is no toilet nearby, the risk of missing urine will be very high.
Imperative incontinence is also called the imperative urge to empty the bladder, which is almost impossible to cope with by willpower. Meanwhile, urgency urinary incontinence is a problem that requires treatment. It should not be ignored, since it significantly worsens the quality of a person's life: he is constantly in need of looking for a toilet, experiences unpleasant sensations, is forced to wear pads to avoid the appearance of an unpleasant smell.
The prevalence of urgent urinary incontinence among women, according to various sources, is 11-20%. Most often, elderly ladies suffer from it. However, you should not put up with this problem. It is possible and necessary to deal with it, especially since modern medicine has all the possibilities for this.
Content:
- Causes of imperative urinary incontinence
- Symptoms of urgent urinary incontinence
- Diagnosis of imperative urinary incontinence
- Treatment of imperative urinary incontinence
- Prevention
Causes of imperative urinary incontinence
The main cause of urgency urinary incontinence is an overactive bladder. The human psyche has increased excitability, which leads to a more rapid transmission of impulses to the muscles of the sphincter and bladder. As a result, the body will react to even minor irritation.
It becomes especially difficult to hold urine when there is some external stimulus nearby, for example, water is pouring, a bright light is on, a sharp sound occurs, etc. Imperative urges will arise even when very little fluid has accumulated in the organ.
The prerequisites for the development of imperative urinary incontinence may be obesity, sudden weight loss, difficult working conditions, a tendency to constipation, radiation therapy, difficult childbirth.
Disruption of connections between pressure receptors in the bladder and the structures of the brain that are responsible for voluntary urination may be due to factors such as:
- Age-related dystrophic changes in the nervous system;
- Hormonal disorders;
- Postponed injuries and operations;
- The presence of tumor processes;
- Frequent infectious and inflammatory diseases of the genitourinary sphere;
- Climax.
As a result of such damage, the signal about urine accumulated in the organ enters the brain too early, and it is pathologically amplified. The muscular wall of the bladder begins to contract, the sphincter expands, urine flows out through the urethra.
Symptoms of urgent urinary incontinence
The following symptoms will indicate imperative urinary incontinence:
- Frequent urge to empty the bladder (pollakiuria). A woman can go to the toilet more than 8 times a day. At night, she can get up to urinate two or more times.
- The urge to urinate will almost always be unexpected.
- The urge to urinate will be strong and difficult to contain.
- The urge to empty the bladder occurs against the background of external stimuli.
- When imperative urinary incontinence is accompanied by prolapse of the bladder, pain in the lower abdomen is common. You may experience a feeling of incomplete emptying of the bladder or a feeling of a foreign object in the vagina.
- During or after intercourse, a feeling of discomfort or soreness in the pelvic area may appear.
- Regular urine leakage provokes the onset of dermatitis in the groin area, promotes the growth of bacteria, recurrence of genitourinary infections, including: cystitis, vulvovaginitis, pyelonephritis.
- The discomfort that a woman experiences against the background of imperative urinary incontinence affects the neuropsychic state. Patients become prone to depression and neurosis.
Distinctive features of imperative and stress urinary incontinence:
| Symptoms | Urge incontinence | Stress incontinence |
| The urge to urinate to urinate is imperative. | Yes | No |
| The number of urinations per knocking exceeds 8 times | Yes | No |
| Urine is released against the background of laughter, coughing, any physical activity | No | Yes |
| A portion of urine | Abundant | Small portions |
| Nighttime awakenings to empty the bladder | Yes | No, or very rarely |
| The ability to hold back the urge | Absent | There is |
Diagnosis of imperative urinary incontinence
To identify a woman's urge urinary incontinence, the following examinations are shown:
- Cough test. In the gynecologist's office, a woman is asked to cough when her bladder is full. This makes it possible to distinguish between imperative and stress incontinence.
- Urination diary. In it, a woman, for several days, records the amount of liquid that she drinks, the number of trips to the toilet, the volume of urine secreted. It is important to take into account the volumes of urine that are released during involuntary emptying of the organ. You should also pay attention to the situations in which urinary incontinence occurs.
- To rule out bladder pathology, such as swelling, stones, ulcers or inflammation, a cystoscopy will be required. This study is an examination of an organ by inserting a microscopic endoscope into it. Access is through the urethra.
- A comprehensive urodynamic examination is indicated to determine the cause of imperative urinary incontinence.
- It is possible to undergo ultrasound of the bladder and pelvic organs.
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To exclude infection, urine is taken for general and bacterial analysis
It goes without saying that any visit to a doctor begins with taking an anamnesis. To find out the cause of urinary incontinence and receive quality treatment, a woman will need to visit not only a urologist, but also a gynecologist.
Treatment of imperative urinary incontinence
Urinary incontinence is not treated with surgery. All patients with this problem are advised to first try to get rid of the existing problem with the help of a non-drug correction program.
General treatments
- If a woman is overweight, then she needs to get rid of it. It leads to an increase in pressure on the bladder, disrupts the normal arrangement of organs. Therefore, without correction of body weight, it will not be possible to get rid of urinary incontinence.
- Diet. To reduce the severity of symptoms of urgency urinary incontinence, a decrease in the consumption of tea, coffee and other drinks containing caffeine is shown. If this is not done, then the risk of missing urine increases. The fact is that all caffeinated products have a diuretic effect. As for limiting fluid intake, if the doctor did not give such recommendations, then you need to drink at least 1.5 liters of water per day.
- The mode of urination should be set. It is necessary to try to visit the toilet during the hours strictly allocated for this event, no matter how strong the urge is. You need to start with small intervals of half an hour, gradually bringing them to an hour or more. Over time, such training will definitely give the desired result.
- It is necessary to train the muscles of the pelvic floor. This will bring them into tone, restore the function of the sphincter, if it has been slightly lost. The better a woman controls the sphincter muscles, the easier it will be for her to control the urge.
Well proven in terms of training the pelvic floor muscles, Kegel exercises. It is necessary to strain and loosen them at least three times a day, keeping the muscles in good shape for at least 3 seconds. It should be noted that training can be carried out almost anywhere, since it is invisible to others. When the muscles are in tone, the exercises can be diversified by performing them in a different rhythm, doing pushing out (as with pushing during childbirth), etc.
Another effective method of dealing with urgency urinary incontinence is biofeedback training. It is aimed at working out the pelvic muscles, but in this case, the force of their contraction is controlled by special equipment. If necessary, you can use electrical muscle stimulation. It has been proven that biofeedback therapy allows you to tone the muscles and achieve maximum control over urination.
Modern medicine offers women a huge variety of simulators that are compact in size and can tone the internal muscles of the pelvis.
Psychological training in combination with other methods of non-medicinal correction is effective for urgent urinary incontinence. If you have strong urges, you need to try to distract yourself as much as possible. For example, you can reflect on the upcoming plans for the day, read an interesting article, etc. The most important task facing a person is to distract from the thought of going to the toilet for a while.
Drug treatment
If general methods of treatment do not bring the desired result, then you can try to get rid of imperative urinary incontinence with the help of drug correction. For this, women are prescribed:
- Medicines aimed at reducing the increased tone of the bladder wall. These are drugs such as: Detrusitol, Driptan, Vesicar, etc.
- Such drugs as Omnik, Caldera, Dalfaz will help to relax the bladder during its filling and improve its blood supply.
- If imperative incontinence is a consequence of menopause, then hormone therapy may be prescribed. Hormones can be used in pill or ointment form.
It should be understood that the therapy of urgent urinary incontinence in women is a complex task that requires an integrated approach. However, the existing problem cannot be ignored. Urine incontinence is extremely common, so there is no need to hesitate to seek help from a doctor. He will prescribe special medications that will significantly improve the quality of life.
Prevention
In order to prevent the occurrence of imperative urinary incontinence as long as possible, you need to use the following simple recommendations:
- An adult must drink at least 1.5 liters of clean water per day. Drinking too much and too little should not be done as it can be harmful to health.
- It is imperative to control your own weight. If you can't cope with extra pounds on your own, then you need to contact a specialist.
- It is important to give up bad habits.
- Timely bowel movements should be monitored, and constipation should be prevented.
- Strengthening your pelvic muscles is important throughout your life, not just when incontinence is a problem.
- It is advisable to create an individual urination regimen. It is difficult to train yourself to go to the bathroom for hours, but it is possible. This is an excellent method for preventing urge incontinence.
Urge incontinence is a serious problem that requires professional therapy. Therefore, it is important to seek help from a specialist, and not to suffer from false shame and discomfort.
Author of the article: Lebedev Andrey Sergeevich | Urologist
Education: Diploma in the specialty "Andrology" received after completing residency at the Department of Endoscopic Urology of the Russian Medical Academy of Postgraduate Education in the urological center of the Central Clinical Hospital No. 1 of JSC Russian Railways (2007). Postgraduate studies were completed here by 2010.
