When you sneeze, cough, or laugh out loud… urine uncontrollably leaks out, this embarrassing “accident” is urinary incontinence. It not only brings many inconveniences to daily life but may also lead to issues such as skin rashes in the genital area, lower abdomen, and thighs, skin infections or ulcers, urinary tract infections, and in severe cases, even affect kidney function.
According to Liu Hechen, director of the Urology Department at Shandong Second People’s Hospital, urinary incontinence can occur at any age, with higher incidence in women and seniors. Male patients are more common over the age of 60, with benign prostatic hyperplasia being the main cause.
Classification and identification are key
1. Urgency urinary incontinence
Mainly characterized by the urgent need to urinate and frequent urination. When there is a strong urge to urinate, it cannot be controlled, and urine flows out uncontrollably. Common causes include aging of the detrusor muscle, cardiovascular diseases, early diabetes, acute cystitis, interstitial cystitis, etc.
2. Stress urinary incontinence
Involuntary leakage of urine occurs during increased abdominal pressure from sneezing, coughing, or exercising. This is more common in women after childbirth or due to defects in the urethra. Additionally, men may experience this after prostate surgery.
3. Overflow urinary incontinence
Common in men, caused by lower urinary tract obstructive diseases such as benign prostatic hyperplasia and urethral stricture, as well as causes like weak bladder contractions leading to chronic urinary retention. When the bladder is extremely full, the pressure inside the bladder exceeds the closure pressure of the urethral sphincter, resulting in urine leakage.
4. Mixed urinary incontinence
This is most commonly characterized by a combination of stress urinary incontinence and urgency urinary incontinence, which can present with one symptom being more prominent, and the symptoms of the two types of incontinence can influence each other.
Urinary incontinence should not be ignored
Experts in urology emphasize prevention and treatment
With age, the function of pelvic floor muscles declines, and symptoms of urinary incontinence may worsen, even accompanied by varying degrees of pelvic organ prolapse and other pelvic floor dysfunctions.
Director Liu introduced that based on the different degrees and types of urinary incontinence, the preventive and therapeutic approaches employed also vary in focus. Among these, medication is the first choice for urgency urinary incontinence, while other treatment options include percutaneous tibial nerve stimulation, sacral nerve stimulation, etc. Furthermore, taking stress urinary incontinence, which has the highest incidence, as an example:
For mild to moderate patients, conservative treatment options include weight loss, quitting smoking and drinking, maintaining a regular routine, reducing intake of caffeinated beverages, actively treating chronic diseases, and avoiding heavy physical labor which may increase abdominal pressure; recording daily fluid intake and urination, consciously extending urination intervals, and training the bladder muscle contraction function; performing pelvic floor muscle training, commonly known as Kegel exercises, consciously practicing active contraction and relaxation of the pelvic floor muscles to gradually increase the strength and control of the pelvic floor muscle group; and using medication under the guidance of a physician to increase urethral closure pressure and improve urethral closing function.
For moderate to severe patients, or those with insufficient effect from conservative treatment, surgical treatment may be considered to repair issues with the bladder and urethra in order to improve urine control.
Finally, Director Liu reminds everyone that urinary incontinence is not an inevitable result of aging but a treatable condition. When symptoms of urinary incontinence occur, it is important to seek medical attention promptly, where a detailed inquiry and examination by a doctor will help clarify the specific cause and formulate a professional treatment plan accordingly.
