There are several types of urinary incontinence in women. Doctors distinguish between stress, urgency, and mixed incontinence. This was told socialbites.ca by a urogynecologist and NI at the Semeynaya clinic in Moscow. Pirogov St. Petersburg State University St. Petersburg Anna Berdichevskaya.
“A woman with stress incontinence loses urine when coughing, sneezing, lifting weights, during physical exertion – that is, with an increase in intra-abdominal pressure. Often this form of incontinence is associated with insufficiency of the ligamentous apparatus of the small pelvis or weakness of the pelvic floor muscles. The causes of weakness of the pelvic floor frame can be different – childbirth, excess weight, passion for sports training with weight lifting. Berdichevskaya explained that in some cases, women with this type of incontinence may benefit from “intimate muscle” training, also known as “kegel exercises.”
Kegel exercises are sequential contractions and relaxations of the pelvic muscles. The pelvic floor is a complex structure consisting of muscles and fascia that are involved in keeping the internal organs in their normal anatomical positions and ensuring their normal functions.
Proper technique is very important when exercising. Therefore, it is important to seek advice from a qualified professional before starting training. If the patient does not know how to contract the muscles correctly, the muscles are first “opened up” with passive training such as extracorporeal magnetic stimulation or biofeedback machines.
“There is also urge incontinence, which is associated with dysfunction of the bladder. In this disorder, the bladder muscles begin to produce sharp contractions as the bladder fills. The nervous system perceives this as an act of urination, so the locking mechanism does not work: the sphincter relaxes, the woman does not have time to run to the toilet. In such cases, Kegel exercises can aggravate overactive bladder, especially if it occurs against the background of chronic urinary retention, ”said the doctor.
The doctor noted that there are more complex forms of urinary incontinence, such as neurogenic, caused by neurological diseases. In addition, urge and stress urinary incontinence are often combined. In this case, treatment depends on which form of urinary incontinence prevails. Typically, the patient is first treated for the urgency component of incontinence and then treated for the stress component.
The easiest way to diagnose any urination disorder is with the urination diaries that the patient fills out over three days. In the diaries it records the frequency and volume of urination, in which cases urine loss occurs, and also shows the strength of the urge and the degree of urinary incontinence. The urologist also noted that all patients with incontinence are shown uroflowmetry – the calculation of the rate of urine flow, because sometimes other forms of urinary dysfunction are hidden under incontinence.
“Urinary incontinence can be caused by urine not leaving the bladder properly. It overflows to a critical volume and urine begins to leak. This condition is called paradoxical ischuria. It can occur against the background of chronic urinary retention, often during prolapse of the pelvic organs. If such a patient is given Kegel exercises, the situation may worsen, ”said Berdichevskaya.