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There are many factors that influence the appearance of stress urinary incontinence. Fortunately, there are several treatment options available.
Problems of the genitourinary system are extensive and sometimes difficult to control. Such is the case with stress urinary incontinence, a condition in which involuntary loss of urine occurs during activities that involve some type of physical force.
Various conditions and risk factors, such as advanced age or obesity, lead to increased intra-abdominal pressure or weakness of the pelvic muscles. This causes an inability of the system to contain the accumulated urine. What are the main characteristics of this disease? Discover them!
Symptoms of stress urinary incontinence
The main symptom of stress urinary incontinence is the leakage of urine in everyday situations that can increase the pressure around the bladder. For example, the following:
- Cough.
- Sneeze.
- Trot.
- Weightlifting.
- have sex
- Receiving trauma or tripping.
The severity of the condition is determined by the volume of flow that is lost involuntarily.
Possible complications of stress urinary incontinence
Although it may seem like a harmless condition, in practice some frequent complications occur. For example, the psychological discomfort to which people who suffer from it are exposed, since it becomes intolerable in severe cases.
The mere thought that any activity can cause urine leaks triggers anxiety attacks, stress, social isolation and even depression. It is important to bear in mind that many of these episodes are easily evidenced by people in the environment, which makes the situation worse.
Another possible complication is irritation of the skin that is exposed to urine. This covers the genital area, the groin, and the inner thighs. In people with a history of dermatitis or jock itch, symptoms tend to be more bothersome.
Without prompt treatment, some patients may experience progressive worsening of the disease. This leads to mixed urinary incontinence, which is the combination of stress incontinence along with “urge” incontinence.
According to a review article shared in Anales del Sistema Sanitario de Navarraurge incontinence causes loss of urine associated with the sudden sensation of going to the bathroom, due to contraction of the detrusor muscle of the bladder.
Why does stress urinary incontinence occur?
The most accepted theory is that stress urinary incontinence occurs due to the weakening of the muscular structures that support and surround the urethra.
For example, it may happen that the external urethral orifices—through which urine passes to the outside— do not resist the pressure caused by urine inside the urethra. This causes the muscle fibers to relax and urine to come out involuntarily.
Risk factor’s
There are certain situations that increase the probability of suffering from this condition. Some of the most important are the following:
- Pregnancy and vaginal delivery. Minor trauma from natural childbirth is likely to cause temporary or permanent damage to the pelvic muscles or nerves. The risk is greater when forceps are used to facilitate the process.
- uterine prolapse. This situation is associated with anatomical changes in which the uterus “slips” or “prolapses” from its usual location into the vagina. In fact, in some cases it clearly stands out. It can be a consequence of vaginal delivery.
- age and gender. It is a more common condition with advancing age, especially in women. From a pathological point of view, this would be influenced by decreased elastic tissue, nerve degeneration, cognitive impairment, immobility, and other factors.
- Obesity. Since excess body weight produces an increase in intra-abdominal pressure, it is logical that urinary incontinence is one of its consequences. Fortunately, losing weight is also associated with significant improvement in symptoms, according to several sources.
diagnostic tests
The clinical manifestations are usually enough for the doctor to diagnose stress urinary incontinence. However, in certain patients certain additional tests may be necessary to assess the anatomical and functional status of the urinary tract.
These are known as urodynamic studies, and they include the following options:
- Cystometry. It is quite useful when a neurological origin is suspected, such as neurogenic bladder dysfunction or some spinal cord injuries.
- Video-urodynamics. A novel technique that uses imaging methods that require contrast to assess the status of the urinary tract.
- Cystoscopy. In essence, it is a procedure similar to a digestive endoscopy. A flexible tube is inserted through the urethra until it reaches the bladder to assess the anatomy of the area thanks to a small camera attached to its end.
Available Treatments for Stress Urinary Incontinence
There are several therapeutic modalities that, although not completely curative, can help improve its consequences.
Physical therapy
It brings together certain methods that have the ability to improve the resistance of the pelvic muscles. Between these, the most popular are Kegel exercises. In another context, these are usually indicated in pregnant women.
Drugs
The list of medications used to treat this and other types of urinary incontinence is not very varied. According to the Cochrane Collaboration, there is evidence that duloxetine (an antidepressant) relieves symptoms and improves quality of life. However, its effect disappears when treatment is stopped.
Specific devices
The urethral inserts and the vaginal pessary They are widely used options for those who do not wish to resort to surgery.
surgeries
As in many other diseases, Surgical alternatives are considered the last possible option due to the associated risks. Some of the techniques include retropubic colposuspension and placement of an artificial sphincter (in men).
Recommendations and lifestyle
In addition to resorting to physical methods to control the disease, it is valid to make some adjustments in lifestyle. Some recommendations are as follows:
- Lose weight.
- Give up harmful habits, such as excessive consumption of alcohol or tobacco.
- Treat constipation.
- Avoid coffee consumption.
Definitely, stress urinary incontinence is a fairly complex condition that negatively impacts physical and mental health. Fortunately, there are multiple modalities to improve symptoms.
Therefore, in case of experiencing its symptoms, the indicated thing is to go soon to the family doctor or to the trusted urologist to receive timely treatment.
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