We often see older women suddenly stunned when coughing or sneezing, and then their expressions become bewildered and difficult to understand. The reason may be due to increased abdominal pressure, causing urinary leakage. This embarrassing illness is often difficult to talk about and can delay the onset of the disease. So, what should we do if we want to improve coughing, sneezing, and urinary leakage?
Leakage of urine is clinically known as urinary incontinence, which refers to the involuntary leakage of urine through the urethra and can occur at any age. According to the different causes of urinary incontinence, it can be divided into stress urinary incontinence, urgency urinary incontinence, mixed urinary incontinence, and fullness urinary incontinence.
Stress urinary incontinence is more common in women after childbirth, often manifested as uncontrolled leakage of urine during increased abdominal pressure such as exertion, physical activity, coughing, laughing, or sneezing. The onset is often related to a decrease in the muscle ability to control the bladder during childbirth, leading to bladder and uterine prolapse.
Urgency urinary incontinence is often caused by an increase in bladder pressure that exceeds the urinary capacity controlled by the urethra, resulting in urine leakage. It is often manifested as sudden and uncontrollable urgency to urinate, and in severe cases, leakage may occur when there is no urgency to urinate.
Filling urinary incontinence is caused by a decrease in bladder emptying capacity or obstruction of bladder outlet, resulting in the inability of the bladder to completely discharge stored urine, leading to leakage of urine after bladder filling, which is more common in males.
To improve urinary incontinence at its root, personalized treatment plans need to be developed based on the type, severity, and cause of urinary incontinence. The treatment for stress urinary incontinence can be divided into non-surgical treatment and surgical treatment.
Non surgical treatment: suitable for patients with moderate to mild stress urinary incontinence, and can also be used as an adjuvant treatment before and after surgery, including primary disease treatment, behavioral therapy, physical therapy, medication treatment, etc.
Primary disease treatment is suitable for patients with chronic abdominal hypertension such as constipation and cough; Behavioral therapy includes quitting smoking, controlling weight, and reducing intake of caffeinated beverages; Physical therapy mainly refers to pelvic floor electrical stimulation therapy, which is suitable for patients who cannot actively contract pelvic floor muscles. Biofeedback therapy, uterine tray and bladder neck filler injection therapy can also be used; Drug therapy is suitable for mild to moderate patients, and drugs such as a1 adrenergic receptor agonists and estrogens can be chosen.
For patients with poor non-surgical treatment outcomes, intolerance, or poor treatment compliance, appropriate surgical treatment can be chosen. For moderate to severe patients and those with pelvic organ prolapse requiring pelvic floor surgery, it is recommended to choose surgical treatment directly. Surgical treatment includes vaginal tension-free mid urethral sling surgery, posterior pubic bladder neck suspension surgery, artificial urethral sphincter implantation surgery, etc.
After treatment, the prognosis of stress urinary incontinence is good, but it still needs to be accompanied by certain rehabilitation training to achieve better treatment results. Lifestyle habits should also be changed, and self testing and management of constipation and frequent urination should be done. In addition, it is recommended to do the following:
1. Actively engage in pelvic floor muscle training, including Kegel exercises, anal sphincter lifting or contraction exercises, generally recommended for 3 months or more, and follow-up is recommended after 12 weeks of training;
2. Pay attention to moderation in diet, avoid overeating, reduce caffeine intake, control weight reasonably, increase intake of fresh fruits and vegetables appropriately, maintain smooth bowel movements, and avoid long-term constipation;
3. Develop a good habit of drinking water every day. It is recommended to drink a total of 2500 milliliters of water per day, but reduce water intake at night;
4. Urinate before going out, before bedtime, or in the morning, develop good hygiene habits, avoid unclean sexual activity, and actively treat primary diseases.
Many diseases can bring troubles to patients' lives, but this is not a reason to delay treatment. Instead, it is more important to actively listen to the doctor's guidance and receive diagnosis and treatment. The most important thing is that proactive prevention is better than cure, and everyone can enjoy a healthy and happy life through an active lifestyle.