Enuresis

Enuresis
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Гінекологія Urology
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Urinary incontinence is any involuntary excretion of urine from the urethra. The problem affects both men and women. But in women it is much more common.

Forms of urinary incontinence

  • Stress incontinence (from the English. Stress - load) - leakage of urine on the background of exercise, sneezing, coughing, sports, etc.
  • Urgency incontinence (from the English. Urgency - urgency) - leakage of urine with a strong urge to urinate. Usually this urination occurs in overactive bladder.
  • Enuresis - nocturnal incontinence, mainly observed in children with functional disorders of the nerve centers of urination (organic changes in the genitourinary and nervous systems are absent).

Next we will talk about stress urinary incontinence in women

Stress urinary incontinence

Prevalence

  • In 20-39 years suffers - 34%
  • In 40-59 years suffers 51%
  • > 60 years suffers from incontinence in 53%.

Risk factors

  • More than one birth
  • Hereditary predisposition
  • Heavy physical activity (heavy lifting and professional sports)
  • Obesity
  • Smoking and chronic lung disease
  • Lock up

Symptoms

Leakage of urine when coughing, sneezing, exercise, sports.
There are 3 degrees of severity:

  • Light - urine leaks with a strong cough, brisk walking.
  • Medium - with light exercise, calm walking.
  • Severe - constant leakage of urine.

There are also 3 degrees of severity depending on the amount of urine loss per day.

  • Light - from 5 to 20 ml
  • Average - from 21 to 74 ml
  • Heavy - more than 75 ml

Diagnosis:

  • A conversation with the patient, during which the situations that lead to leakage, the time of occurrence of leakage, risk factors, previous operations and previous treatment are determined.
  • Diary of urination. For 3 days, it records: frequency of urination, volume of urination, whether there were episodes of leakage, as well as data on the nature and volume of fluid consumed.
  • General urinalysis - required to rule out lower urinary tract infection.
  • Test with a pad - pads that are weighed before and after the test, and the change in weight accurately determines - what is the loss of urine. It is desirable to conduct such a test during the day.
  • Cough test - a patient in a gynecological chair is asked to cough or stand with a full bladder. A positive test is a loss of urine with a cough.
  • Uroflowmetry - determination of the rate of urination.
  • Ultrasound of the bladder to determine residual urine.

Treatment:

  • Urological pads and moisture-retaining underwear, uro-condoms for men - are not a full-fledged treatment, but help to improve the quality of life.
  • Weight loss, regular exercise, smoking cessation and reduction of consumption of beverages containing caffeine (tea, coffee)
  • Pelvic floor muscle training. The pelvic floor muscles play an important role in urinary retention. Training these muscles (Kegel exercises) can be done independently or under the supervision of a specialist or special devices.
  • If the change in lifestyle is ineffective, the doctor selects drug therapy or, depending on the severity of symptoms, offers surgical treatment. Surgical treatment is to install a special vaginal loop to strengthen the walls of the urethra.

Conclusion:

Leakage of urine, even in small quantities, regardless of gender or age - is not the norm. Effective treatment exists and is available. It only remains to correctly diagnose and get your hands on a reliable specialist.
 

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