Urine pants, clinically known as urinary incontinence, is caused by the loss of bladder sphincter or neurological dysfunction, leading to the loss of self-control in urination and the involuntary outflow of urine. It can occur in any season, but is more severe in autumn and winter. People of any age and gender can get sick, but it is more common in the elderly and women.
Urinary incontinence can be caused by various factors such as psychological factors, neurological disorders, childbirth, trauma, etc.: ① Congenital factors: urethral lesions, such as hypospadias; ② Trauma: trauma during childbirth in women (especially multiple deliveries), pelvic fractures, etc; ③ Surgery: Prostate surgery, urethral stricture surgery, lumbar spine surgery, pediatric urethral valve surgery, etc; ④ Neurogenic bladder caused by diabetes, cerebral hemorrhage, cerebral infarction, congenital spina bifida, etc.
Normal male urine control relies on two parts of the urethra: first, the proximal urethral sphincter, which includes the bladder neck and the prostate urethra above the seminal vesicle. 2、 The distal urethral sphincter can be divided into two parts: ① the posterior urethra below the seminal vesicle. ② External urethral sphincter. Regardless of gender, the bladder neck (the smooth muscle of the urethra controlled by the sympathetic nervous system) is the main force controlling urine. For males, if the proximal urethral sphincter function is completely lost (such as after prostate enlargement surgery) while the distal urethral sphincter is intact, they can still control urination as usual. If the function of the distal urethral sphincter is simultaneously damaged, it can cause varying degrees of urinary incontinence depending on the severity of the damage. For women, complete loss of bladder neck function can cause stress urinary incontinence.
Common urinary incontinence can be divided into overflow urinary incontinence, true urinary incontinence, acute urinary incontinence, and stress urinary incontinence.
① Overflow urinary incontinence is caused by urinary retention due to severe mechanical (such as prostatic hyperplasia) or functional obstruction of the lower urinary tract. When the internal pressure of the bladder rises to a certain extent and exceeds the resistance of the urethra, urine continuously drips out of the urethra. The bladder of these patients is in an inflated state.
② True urinary incontinence is caused by the complete loss of urethral resistance, which prevents the bladder from storing urine. When the patient stands, all urine flows out of the urethra.
③ Urgency urinary incontinence can be caused by strong local stimuli such as partial motor neuron damage or acute cystitis, and patients have severe symptoms of frequent urination and urgency. Urinary incontinence occurs due to strong non inhibitory contractions of the detrusor muscle.
④ Stress urinary incontinence is when urine flows out of the urethra when abdominal pressure increases (such as coughing, sneezing, laughing, going up stairs, or running).
For conditions such as fullness urinary incontinence and urgency urinary incontinence, it is necessary to identify the cause and remove it through medication or surgical intervention to achieve treatment goals. For stress urinary incontinence, if the symptoms are mild, pelvic floor muscle rehabilitation training can be performed: by enhancing the tension of pelvic floor muscles and urethral muscles, the reactive contraction force of muscles under pressure can be increased, thereby improving the function of the urethral sphincter muscle; For critically ill patients, surgical intervention can be used to achieve treatment goals.