Urinary incontinence in women over 40 years of age is a common problem that you should not be ashamed of. Modern techniques will help cope with urine leakage, restoring self-confidence to patients. At the first warning signs You should consult a doctor, he will help you choose the right treatment.

What is the cause of the problem

Urinary incontinence in women after 40 years of age, the causes are very diverse, is quite common. According to medical statistics, about 45% of premenopausal women suffer from the disease. The disease may be silent or make itself felt sharp deterioration well-being. Among the main causes of the disease:

• hormonal imbalance;
• overweight and obesity;
• frequent childbirth accompanied by complications;
• cystitis and other inflammatory diseases;
• smoking;
• age-related atrophy of the pelvic muscles;
• chronic constipation;
• infectious diseases of the genitourinary organs and their consequences;
• surgeries on the pelvic organs;
• long-term use of potent medications.

Doctors highlight following forms illnesses

1. Stress or involuntary incontinence. Occurs without the urge to urinate at any time of the day. Most often occurs during short-term stress: lifting heavy objects, sneezing, laughing, or a sudden change in body position.
2. Urge incontinence(hyperactive syndrome) bladder). The urge to urinate occurs abruptly and makes it impossible to empty it under normal conditions.
3. Mixed incontinence. Combines both of the above options. The patient feels an urgent need to empty the bladder during coughing, laughing, or sudden movement.
4. Nocturnal enuresis. Leakage of urine without a pronounced urge, occurring at rest, usually during sound sleep.
5. Constant leakage. Usually associated with acquired atrophy of the pelvic muscles. May occur after surgery, trauma, sudden hormonal imbalance. Sometimes the reason is congenital anomaly, worsened with age (for example, displacement of the ureter).
6. Undermining. Prolonged drip leakage after normal emptying of the bladder. Caused by leakage of urine into the diverticulum of the urethra or vagina. May get worse with age.

Symptoms and manifestations

It’s easy to understand that it’s time to see a doctor. At first, a woman may notice a single leak. Gradually the problem arises more and more often. In addition to the involuntary loss of urine, the following symptoms indicate the disease:

• unpleasant odor;
• itching and burning in the urethra associated with constant irritation;
• swelling and redness of the external genitalia;
• minor inflammation;
• short-term increase in temperature;
• general deterioration of health.

Unpleasant sensations can be not only physical, but also psychological. Woman feels constant worry, is afraid to relax, tries to constantly control the most insignificant urges. This can lead to neurosis and even depression. It is no coincidence that the therapy program includes not only medication, but also sessions with a psychologist.

Diagnostic methods

At the first alarming signs, you need to contact a therapist, who can provide a referral to specialized specialists. First, the doctor collects anamnesis, summarizing information about childbirth, termination of pregnancy, infectious (including sexually transmitted) diseases, injuries and operations. It is necessary to take a blood test to exclude such dangerous ailments as diabetes or stroke.

After this, the woman visits a gynecologist and takes a smear from the cervical and vaginal canals. The next stage is an ultrasound of the bladder and kidneys. After this, the doctor uses a series of tests to assess the amount of urine excreted, measure the tone of the perineal muscles and the pressure in the urethra.

Treatment Options

Only a doctor can explain how to treat urinary incontinence after 40 years. Therapy depends on the type of illness, individual characteristics organism, the presence or absence of other chronic diseases. For stress incontinence not associated with the urge to urinate, minimally invasive surgical intervention is recommended. There are many different techniques, but the loop hold is especially effective. After surgery, a woman should be careful about her health, avoiding hypothermia, which can lead to relapse.

If the patient is not ready for surgery, she will be offered conservative therapy. Magnetic stimulation of the pelvic organs and biofeedback therapy have proven themselves well. Useful Kegel exercises associated with alternating tension and relaxation of the muscles of the perineum and anus. Special gymnastics will be a good preventive measure for women at risk. Hormonal treatment is recommended during premenopause. It not only stops involuntary urine leakage, but also improves general condition female patients.

With an overactive bladder, women are prescribed medication therapy in combination with therapeutic exercises. Surgery is contraindicated in such patients. Bedwetting in women over 40 is also treated with medications. At the same time appointed behavioral therapy and physical therapy. Warming up, microcurrents, and the use of electromagnetic pulses give good results.

From medical supplies Driptan is most often prescribed. It dampens impulses from the outside nervous system while relaxing the bladder muscles. The course and dosage are prescribed by the doctor; self-medication is strictly prohibited. Abuse of medications can worsen the patient’s condition, transferring the disease from the acute phase to the chronic phase.

Traditional medicine recipes can also help with incontinence. Good effect gives a course of decoctions medicinal herbs: St. John's wort, marshmallow root, centaury, bear's ear, nettle, yarrow. 2 tbsp. spoons of the collection are brewed with 500 ml of boiling water, heated for 5 minutes and infused in a thermos. This portion should be drunk in small doses throughout the day. The decoction is useful lingonberry leaves, as well as lingonberry or cranberry juice, which has a general strengthening and antioxidant effect.

Super-absorbent formulas have been developed especially for women. panty liners, capable of holding a significant amount of urine. They protect clothes, eliminate unpleasant odors and restore a feeling of confidence. In pharmacies you can select products of the desired size and degree of absorbency, intended for daytime or nighttime. They need to be changed frequently to prevent inflammation and irritation of the genitals.

A mandatory point of therapy is proper nutrition. A woman should eat more fruits, vegetables, and low-fat fermented milk products, activating beneficial microflora. It is advisable to reduce the amount of animal protein, completely eliminate fatty foods, smoked foods and pickles. Alcohol, which can provoke an exacerbation, is strictly prohibited. It is advisable to give up not only strong drinks, but also beer, cocktails, and energy drinks that contain high doses of caffeine.

Urinary incontinence in women over 40 years of age, which must be treated under medical supervision, is very common. Timely diagnosis and proper treatment can eliminate the most unpleasant symptoms, and after a while completely get rid of the problem. With timely treatment, relapses and complications are rare.

The issue of urinary incontinence is well known not only to urologists. Large quantity people are faced with this sensitive issue, especially in old age. Urinary incontinence in older women brings a lot of trouble, but due to the peculiarities of their upbringing, people are ashamed to talk about their problem not only to specialists, but even to close people.

Modern medicine solves this problem; there is every chance of returning to former comfort and desired activity, which patients are deprived of due to possible sudden urination.

Different types of disease

Urinary incontinence occurs in older men and women. There are the following types of urinary incontinence:

• stressful;
• urgent;
• mixed;
• transient;
• overflow incontinence.

Treatment of urinary incontinence in women depends on the type and complexity of the disease. As a rule, according to epidemiological analysis of data, patients with stress (50%), urge (14%) or mixed (32%) type of incontinence come to the decision about the need for treatment.

Stress urinary incontinence is caused by a difference between the pressure inside the bladder and in the urethra; due to the lack of contractions of the muscular lining of the bladder, the pressure in it increases. Uncontrolled loss of urine is observed with involuntary movements (coughing, laughing, sneezing) or with intentional increase physical activity(running, changing body position, lifting heavy objects).

This disease is diagnosed:

• in women of reproductive age (in the form of complications after childbirth, accompanied by injuries);
• with the onset of menopause;
• at congenital pathologies connective tissue;
• after gynecological or urological surgical intervention;
• as a result of overloads;
• as a complication after respiratory diseases;
• for other reasons leading to increased pressure in the abdominal cavity.

What drugs are used to treat the disease?

Urinary incontinence in older women is usually caused by a lack of estrogen. Hormonal therapy is designed to restore blood circulation, nutrition processes and tissue regeneration, restore tone to the pelvic floor muscles and establish other vital processes in the body that are disrupted as a result of hormonal changes.

Medicines for urinary incontinence are prescribed after a thorough comprehensive examination of the woman’s body. Doctors often prescribe Gutron, Ubretide and Cymbalta.

Gutron are tablets for urinary incontinence, which are prescribed in conjunction with mandatory monitoring of blood pressure. They restore contractile function smooth muscle tissue organs of the genitourinary system. Ubretide increases the tone of the smooth muscles of the bladder, ureters and urinary tract. Prescribed for diagnosing low muscle tone. Cymbalta is a medicine that restores the contractile activity of the bladder and urethral sphincter muscles by stimulating the pudendal nerve.

Urgenic (imperative) urinary incontinence occurs due to a sudden involuntary contraction of the muscles of the bladder, resulting in an unbearable desire to go to the toilet, while urine may flow out spontaneously.

Depending on the frequency of urges, with or without loss of urine, a distinction is made between frequent urination during the day (more than 8 times) and at night (2 or more times), uncontrollable urge to urinate, and urge urinary incontinence. This disease is diagnosed:

• as a result inflammatory processes genitourinary system;
• with the onset of menopause;
• as a result of neuralgic diseases;
• as a complication after surgery;
• for diabetes;
• as a result of loss of muscle tone due to a sedentary lifestyle.

Drug treatment of urinary incontinence in older women

For urge urinary incontinence in older women, associated with a decrease in estrogen levels during menopause, the drugs described above are prescribed as treatment. Omnic, Spazmex, Driptan, Detrusitol and Vesicare can be prescribed separately or in combination with hormonal therapy.

Omnic leads to a decrease in tone smoothly muscle cells bladder neck, prostate gland, prostatic part of the urethra and improving the functioning of the muscle tissue of the bladder. Spazmex relieves spasms, relaxes smooth muscles in the urine excretory system. Driptan is an antispasmodic that has a myotropic effect, causes relaxation of the muscles of the bladder and urethra, due to which the volume of the bladder increases and the number of urges to urinate decreases.

Detrusitol - improves urodynamics, reduces the frequency of the urge to urinate, eliminates urinary incontinence and reduces its average volume. Vesicare - exhibits antispasmodic activity. The effect develops in the first days of therapy and requires stabilization within 3 months of treatment. The effect can last up to a year.

Mixed urinary incontinence combines symptoms of stress and urogenic incontinence. Urologists and gynecologists have not yet come to a clear conclusion regarding the treatment of patients with this disease. An objective positive result is observed in the use of conservative therapy as preparation for surgery, over a period of 2-3 months, as well as in postoperative period.

Thanks to an individual examination and the correct selection of therapeutic agents for the treatment of urinary incontinence in older women, this annoying and debilitating illness can be forgotten forever. The duration and effectiveness of various treatment methods is determined privately by the doctor, taking into account the age and nature of the disease.

Pelvic muscle training

This type of training is an excellent tool for drug treatment urinary incontinence. Special exercises, designed to increase muscle tone of the urinary and reproductive systems were invented by the American doctor Arnold Kegel. These exercises are best used as a preventive measure to prevent urinary incontinence in older people, rather than as a treatment for an existing disease. According to this method the patient must learn to contract the perineal muscles and maintain a state of tension for at least 15 seconds.

The essence of the method is that the muscles, being in good shape, allow you to control the process of urination, since they are the ones that are involved when you need to interrupt the stream of urine. The point is that a person always has good control of trained muscles and can restrain the urge to urinate when coughing or other sudden movement that increases pressure in the abdominal cavity.

The success of such therapy depends on the regularity and correctness of the exercises. The first results may appear within a couple of weeks, with the disappearance of urine leaks during light physical activity.

The problem is that the duration of such treatment is difficult to determine; it is possible that with the onset of a certain age the need for such training will have to be met daily. Patients who are unable to perform exercises due to any hindering factors may be offered electrical stimulation methods muscle contractions. The effect of such procedures will be no less noticeable, however, regular visits to a special medical center will be required.

Surgical intervention

It is a measure of last resort and is resorted to in cases where conservative methods treatments did not give the desired results. Surgeries are used most often in the treatment of stress urinary incontinence rather than in the urge form.

The surgical operation is planned taking into account the individual characteristics of the course of the disease and the patient’s health status. When surgically treating urinary incontinence in elderly women, the most gentle methods of anesthesia are chosen, as well as the safest surgical techniques with little blood loss.

Urinary incontinence is not a death sentence, because the disease is not always associated with the onset of old age, but only indicates some abnormalities in the functioning of the body, which are eliminated various methods. There is no need to endure inconvenience, shame and constant voltage When you are in the company of other people, it is important to seek qualified medical help in a timely manner.

Kidney cyst: symptoms, diagnosis, treatment and prevention

When a kidney cyst is diagnosed, the question immediately arises: “What is it?” This is a benign anomaly in the form of a rounded bubble (connective tissue capsule). These neoplasms can be single or multiple and appear at any age, but more often after 40 years. Renal cysts initially develop from a structural segment of the renal tubules, but subsequently become detached from it. Inside the bubble there is a translucent yellow liquid.

Kidney cysts do not always require radical treatment(removal) - sometimes drug therapy and dynamic monitoring of the tumor in a clinical setting are sufficient. This anomaly cannot be left without medical attention - it can have disastrous consequences for the entire genitourinary system.

Reasons for education

The causes of the formation of a connective tissue capsule sometimes remain unclear. In a stable condition, the cyst of the left kidney and the cyst of the right kidney do not cause pronounced pathological symptoms and can be discovered completely by accident - during a routine ultrasound internal organs, intravenous urography or others diagnostic procedures.

The reasons for the development may be:

• Hereditary predisposition;
• Systemic pathologies (tuberculous sclerosis, chronic pyelonephritis);
• Oncological kidney diseases;
• Traumatic lesions;
• Infectious diseases of the genitourinary area.

Direct factors that lead to the appearance of cysts in the kidneys are processes of intense hyperplasia (division) epithelial cells lining the kidney tubules from the inside.

Symptoms

In 70% of cases, the symptoms of a kidney cyst are not expressed or expressed to a mild degree. People can for a long time living with this neoplasm and not knowing about its existence.

However, in 30% of cases, a kidney cyst still manifests itself, causing:

• Painful sensations in lumbar region backs;
• Feeling of discomfort in the abdominal cavity (in the presence of large cysts in the kidneys);
• Hematuria (presence of blood in urine: often this sign is of an implicit nature and is revealed during laboratory analysis);
• Secondary arterial hypertension(increased pressure);
• Obstruction of the renal calyces.

In addition, signs of a kidney cyst can manifest themselves in the form of general dysfunction of the genitourinary system. Often, patients (usually women) develop dysuric disorders. Often the neoplasms considered contribute to the exacerbation of existing kidney ailments– in particular, pyelonephritis.

If a doctor suspects an anomaly such as a kidney cyst, the symptoms of which are almost always nonspecific, a comprehensive diagnosis must be carried out.

Possible complications

Over time, a cyst on the kidneys may begin to increase in volume, compress the ureter and pelvis of the organ, thereby causing aching pain. If the abnormality, which gradually grows, is not treated radically, rupture may occur. Sudden spontaneous opening of a kidney cyst can lead to infection and cause hemorrhage.

Infection, the causes of which can be very different, gives typical signs acute pyelonephritis:

• High temperature;
• Weakness and dizziness;
• Lower back pain;
• Painful and frequent urination;
• Pain in joints and muscle tissue.

Renal anomalies can be combined with malignant kidney tumors. Sometimes a benign cyst on the kidney can develop into cancer.

A large kidney cyst can lead to compression of the kidney tubules and cause chronic renal failure, which is accompanied by thirst, an increase in the amount of urine (polyuria), chronic physical inactivity, and hematuria.

In addition, even a small kidney cyst, according to some urologists, can at any time lead to serious disruptions to the functioning of the genitourinary system.

Diagnostics

Making a diagnosis begins with collecting data about the symptoms of the disease, as well as accompanying pathologies patient. Then it is carried out external inspection and palpation of the lower back and abdominal cavity. Multiple cysts in the kidneys can be detected by palpation: the affected organs with numerous anomalies have a bumpy surface.
The list of diagnostic procedures includes:

• A blood test to detect anemia, low protein levels and increased amount urea;
• Urinalysis, which reveals hematuria, high quantity leukocytes (the specific gravity of urine is also determined - in chronic failure, which often accompanies a cyst in the kidneys, it is reduced);
• Ultrasound of the kidneys - allows you to identify the location of anomalies, their size and quantity, as well as assess the effect of neoplasms on nearby tissues and organs;
• Contrast angiography, in which cysts in the kidney are identified as an avascular area;
• Excretory urography;
• Computed tomography.

The most serious attention should be paid to identifying and classifying this anomaly, since an erroneous diagnosis can lead to serious consequences. There are often cases when malignant tumors are diagnosed as benign cysts. For this reason, it is better to undergo the examination in a specialized medical center equipped with functional and up-to-date equipment.

Differential diagnosis allows you to exclude other diseases with similar symptoms - malignant neoplasms, abscess, Williams tumor, hydronephrosis, acute pyelonephritis.

Therapy

Radical treatment

Treatment of a kidney cyst is carried out in cases where there are severe symptoms (increased pressure, pain, disruption of the excretory system) or when the tumor is larger than 5 cm. It is necessary to treat such a cyst, otherwise the consequences can be unpredictable. The specialist decides what actions to take.

Several decades ago, in such cases, the kidney cyst was removed through an incision, that is, open abdominal operations, and this is always a risky and dangerous procedure that can cause negative consequences in the form of bleeding, infection and suppuration. In modern medical institutions men and women are relieved of kidney cysts using minimally invasive and low-traumatic operations. Healthy tissues and organs are minimally damaged.

This operation is called laparoscopy, and it is performed using an endoscope, which, through a miniature incision, delivers the necessary surgical instruments to the affected area. The progress of the surgical intervention is monitored on the monitor, so the doctor has the same full visual access to the organs as with an open incision. Removal of cysts in the kidneys using the laparoscopic method occurs together with capsules, which eliminates the possibility of relapse.

After the operation, the patient undergoes a rehabilitation course, which includes treatment:

• Antibiotics (a gentle course is used to prevent infection);
• Painkillers;
• Anti-inflammatory drugs.

An alternative to laparoscopy is puncture, which is even less invasive, but, unfortunately, does not contribute to the complete elimination of the anomaly. During such an operation, the main negative symptom which a kidney cyst causes is compression of the organ.

IN abdominal cavity Under visual ultrasound control, a special needle is inserted, which pierces the bladder, after which its contents are sucked out. Sclerotherapy can also be performed - the introduction of alcohol into the capsule, which kills cells programmed for further division benign neoplasm. The procedure for puncturing a cyst in the kidneys takes no more than 20 minutes.

The decision of which surgery to perform depends on many factors, but mainly on the current clinical picture.

Conservative therapy

Special therapy for stable kidney cysts that do not affect the well-being of patients and the condition of their internal organs is not required. Doctors may prescribe medications that stabilize blood pressure or improve the functioning of the urinary system, nothing more.

Note! There are no specific medications used against kidney cysts.

This anomaly can also be treated or maintained in a stable state with the help of proper nutrition. A diet for kidney cysts involves limited salt intake, as well as spicy and pickled foods.

It is necessary to adhere to other principles of healthy eating:

• Monitoring fluid intake (especially for those patients who have edema and signs of heart failure);
• Exclusion from the menu of canned food, fast food, coffee, soda, sweets;
• Limiting protein intake - especially in the form of red fatty meat;
• Increase in diet plant food: fresh vegetables, fruits, cereals, legumes.

Prevention

Unfortunately, there are no 100% measures to prevent kidney cysts. But some actions can still prevent the appearance of benign renal tumors:

• Timely therapy infectious pathologies urinary system;
• Protecting the kidneys from injury and hypothermia;
• Regular (every 1-2 years) examination of all internal organs.

It is best to do an ultrasound or CT scan not in ordinary clinics, where the equipment may be outdated and outdated, but in a specialized specialized institution. This makes it possible to identify pathologies at the earliest stages of their formation.

A kidney cyst is a fairly common phenomenon, so there is no need to panic after it is discovered during examination. If the size of the capsule is small and your health is stable, there is no need to undergo urgent surgery: you only need observation in the clinic and reasonable control of your own health.

Types of kidney cysts:

1. Renal sinus cyst - symptoms, treatment.
2. Renal parenchymal cyst: symptoms, complications, treatment.
3. Parapelvic cyst of the kidney.

Overactive bladder is a disease characterized by a strong urge to urinate, which the patient cannot control in the absence of various genitourinary infections and other pathologies in this area. Urinary incontinence leads to serious problems in the patient's life.

Timely diagnosis of the disease and contacting a specialist will help overcome the pathology. The cause of the disease is often a change in the center of the cerebral cortex, which is responsible for the process of urination. It is important to promptly identify the negative factor influencing the formation of pathology and eliminate it. Lack of treatment leads to serious mental disorders.

• Reasons for the development of the disease
• Symptoms
• Diagnostics
• General rules and methods of treatment
• Drug therapy
• Nutrition and lifestyle rules
• Surgical intervention
• Muscle training exercises
• Prevention measures

Reasons for the development of the disease

Both sexes are affected, but women suffer from overactive bladder more often than men. The myth that the disease is only female is due to the negligent attitude of the stronger sex towards their health. After 40 years, most patients are women, while men complain of unpleasant symptoms more often after 60 years.

About 70% of patients are embarrassed by their disease and prefer to cope with it on their own, which reduces the patient’s quality of life. Not many people are informed about the disease and believe that it cannot be cured. Don't hesitate to ask your doctor for help. Proper treatment and timely therapy will help normalize sleep and eliminate constant discomfort.

Experts distinguish two types of disease:

• idiopathic (the exact reasons for its formation have not yet been clarified). This form of overactive bladder occurs in 65% of all cases;
• neurogenic (provoke diseases of the nervous system, Parkinson's, multiple sclerosis). This type of pathology occurs in 25% of the total number of patients.

Doctors also tend to identify a third type of pathology, which is characterized by the appearance clinical signs overactivity of the bladder in the absence of disturbances in the functioning of the organ. This form of the disease is diagnosed in 10% of patients and often affects women.

Find out how to relieve pain when renal colic in women and further treatment pathology.

About preparation for cystoscopy of the bladder and the procedure is written on this page.

The disease occurs in every fifth inhabitant of the planet, which causes the formation of an unpleasant pathology:

• neurogenic factors (these include damage to the peripheral and central nervous systems): stroke, osteochondrosis, multiple sclerosis, injuries spinal cord, Parkinson's disease. This category also includes complications after spinal surgery;
• idiopathic factors (the reasons for their development are not yet known to science).

Other negative factors include:

• age. The aging process of the body leads to various pathologies: collagen fibers grow, blood flow is disrupted, which forms urothelial atrophy and denervation;
• depression, chronic nervous tension, emotional instability (mental disorders are more common among the fair sex);
• inflammatory processes in genitourinary system women.

Doctors have found that women's predisposition to bladder overactivity is due to low content in their brains a substance called serotonin. Its level decreases significantly during hormonal fluctuations (pregnancy, menopause), making a woman vulnerable to illness.

Symptoms

It is quite easy to suspect the course of a woman’s illness. Pathology makes itself felt with sharply negative symptoms:

• frequent urination (regardless of fluid consumed). A pathology is considered to be emptying the bladder more than eight times a day, more than twice at night;
• urinary incontinence, especially with sudden movements, coughing, sneezing, physical activity;
• sudden attacks of an urgent desire to empty the bladder, which are difficult to restrain (even with a small amount of accumulated urine);
• urine dripping, discomfort during this process;
• feeling of the bladder not being completely emptied.

Severe cases are characterized mental disorders, the formation of complexes. Patients stop communicating with relatives and friends and work remotely. With an overactive bladder, the above symptoms may appear and then disappear. Sometimes the only signs of the disease are an unbearable urge to urinate.

Diagnostics

At the doctor’s appointment, the specialist will collect all the information about the patient, taking into account the medical history of his relatives. A urination diary, which the patient can fill out independently, will help in diagnosis. within three days.

It is important to write down a few main points:

• frequency of bladder emptying, volume of fluid released;
• number of drinks consumed;
• episodes of incontinence;
• accompanying sensations and other important circumstances.

When making a diagnosis, the presence of diabetes mellitus in a woman, the course gynecological problems, neurological diseases. It is important to know about childbirth surgical interventions in the perineal area. Additionally, a number of studies are carried out: ultrasound of the kidneys, uterus, bladder, and other organs if necessary; They do a urine test and perform a culture to identify pathogenic microflora.

Don't be alarmed if your doctor makes an appointment with a psychologist. Many cases of urinary incontinence are associated with emotional experiences female patients.

General rules and methods of treatment

Due to the clinical picture, individual manifestations in each patient, and the unclear etiology of the disease (in some cases), an exact algorithm for the treatment of bladder overactivity has not yet been developed. There are several effective techniques, allowing to relieve unpleasant symptoms and improve a woman’s condition. Used to treat the disease integrated approach. Strict execution of instructions, in most cases, leads to the expected result.

Drug therapy

Taking any medications on your own is strictly prohibited! Medicines are aimed at suppressing special receptors responsible for contraction of the bladder muscles. Medicines have a strong effect on the body; their use, dosage, and selection of a specific medicine are the prerogative of the physician.

To eliminate bladder overactivity, use:

• Driptan. Effective, but often causes drowsiness, dry mouth, apathy;
• Trospium chloride. Its positive effect and safety have been clinically confirmed. Compared to the first medication, this one is much better tolerated.

The symptoms of the disease subside five days after treatment, a persistent therapeutic effect is observed after a month of use. The downside of medications is that stopping them threatens a relapse of the disease.

Nutrition and lifestyle rules

Make life easier with availability unpleasant disease, women are recommended to change their usual lifestyle:

• exclude carbonated drinks, coffee, tea from your diet. These fluids irritate the walls of the bladder, increasing the chances of developing a disease;
• drink throughout the day; before going to bed, refuse any liquid. This advice will help you get up less to go to the toilet and normalize your sleep;
• Try to empty your bladder completely. After emptying, relax, then try again to completely get rid of the urine. Repeat the manipulations every time you go to the toilet. Over time, your body will get used to eliminating urine completely, making your life easier;
• will help get rid of an unpleasant odor and protect yourself from awkward situations special gaskets, diapers for adults. Such hygiene devices will absorb the released liquid.

Surgical intervention

Operations are indicated for patients in advanced cases when conservative treatment methods do not give the desired result:

• detrusor myectomy (doctors remove most of the muscles that react violently to nerve impulses from the brain);
• denervation of the bladder. The operation represents the closure of impulse transmission paths, causing contraction detrusor;
• intestinal plastic surgery. Radical operation, in which part of the bladder wall is replaced with an intestinal wall (not capable of imperative contractions).

Each operation helps reduce unpleasant symptoms and improve the patient’s quality of life.

Muscle training exercises

Kegel exercises are known to many women. They are used not only to treat bladder overactivity, but also before the birth of a child, facilitating the birth process:

• Squeeze your muscles slowly, as if trying to stop the process of urination, hold for a few seconds, relax;
• abbreviations. Relax and tense your muscles at maximum speed;
• pushing out. Try to push as if you are trying to have a bowel movement.

Repeat all exercises ten times daily. With each subsequent week of therapy, increase the number of repetitions by five times, reaching a maximum of 30 repetitions. Perform all manipulations simultaneously with proper breathing.

Look at the list of herbal uroseptics and find out the rules for their use.

the rules for preparing for excretory urography of the kidneys are written on this page.

Prevention measures

There are several ways to prevent the formation of an unpleasant disease in women:

• monitor your weight, see a gynecologist regularly;
• train the pelvic muscles, monitor the condition of the spine;
• do not overuse coffee and tea.

The following video explains in more detail the differential diagnosis and treatment options for overactive bladder in women:

The urinary bladder (UB) performs two main tasks in the body: storing urine, which is secreted by the kidneys, and emptying it. Before urine is removed from the body, the MP sends a warning signal to the brain.

The accumulation and emptying of MP is controlled by special muscles, sphincters. They shrink, preventing urinary incontinence in women over 60. And they are in a relaxed state when it comes time to urinate. Every healthy person involuntarily controls the sphincter mechanism.

Why is urinary incontinence detected in women after 60?

TO lost control above the sphincters can result from a set of factors:

• The pelvic muscles are in a flabby state. In this case, they are unable to support the internal organs.
• Lack of estrogen (important female hormone not only at sixty years old).
• Unsuccessful postoperative period (for example, surgery in the uterus).
• An infection has entered the urogenital canals.
• Prolapse of the vaginal/uterine wall.
• Among the rarer ones are stroke, stress, urolithiasis.

There is a generally accepted form for describing bladder incontinence. It includes six points:

• Stress incontinence. Occurs when there is a change in state (getting up, laughing, walking fast). The urinary tract does not transmit a signal to the brain about possible urination.

• Urgentnoe. Such urinary incontinence in women occurs after an urgent signal from the bladder. Due to the speed of the signal and the intense desire, it is almost impossible to get to the toilet in time.
• Mixed. An urgent urge to go to the restroom after a change in state (getting up, laughing, etc.)
• Nocturnal enuresis. Involuntary urination during sleep. It can also appear during the daytime.
• Constant leakage of urine. Indicates problems connecting the sphincters to the bladder. May indicate an abnormal position of the ureter. This item rarely occurs in women over 60 years of age.
• Dripping after full urination. Occurs due to excessive accumulation of urine or inflammation of the urethra.

If you suffer from any form of incontinence, consult a doctor immediately for diagnosis and prompt treatment.

Diagnosis and treatment

Comprehensive diagnostics usually includes:

• Anamnesis. Your detailed story about the sensations before incontinence, about possible reasons involuntary loss of urine.
• Vaginal smear analysis.
• Ultrasound examination of the ureter and kidneys.
• Leakability test.
• Conducting a urodynamic study (keeping an incontinence diary, comparing bladder pressures, profilometry of the urethra, examination of the sphincter muscles).

After collecting data and tests, the doctor can announce a diagnosis and treatment regimen depending on the form of incontinence. Conservative and surgical methods are used to treat incontinence. Conservative treatment includes:

• A course of medications. For example, if an overactive bladder is detected, the doctor may prescribe Spazmex for two to three months.
• Therapeutic gymnastics of the perineal muscles. Kegel exercises not only prevent urinary and fecal incontinence, but also improve blood circulation in the pelvic organs as a whole. Before class, be sure to empty your bladder.
• Magnetic therapy (stimulation of the neuromuscular part of the pelvic floor).

Enuresis has a comprehensive treatment: physiotherapy and a course of medications.

Surgery is a popular minimally invasive loop operation. This is a correction of the internal sphincter. A “sling” (loop) made of natural/synthetic materials is placed. It becomes an additional support for MP against incontinence.

Odor control

• The urine pad should be changed after each episode of incontinence. Wash the external genitalia regularly (or use wet wipes for intimate hygiene).
• Don't limit yourself to water! This will not solve the problem, but will make it worse. Water affects the concentration of urine, and if you don't drink enough liquid, your urine will only smell stronger.
• Take vitamin C (if there are no contraindications) or add cranberry juice to your diet. This will help improve the smell of your urine.
• You can try food supplement Nullo. It neutralizes urine odor and eliminates unpleasant odors from the mouth, and sweat.

Products that should be avoided if you have urinary incontinence: coffee, alcoholic drinks, fresh citrus fruits or juices from them, chocolate and other sweets.

According to doctors, every second woman aged 60-70 years experiences urinary incontinence. However, not every one of them seeks medical help. It is important to understand that there is nothing to be ashamed of here. This is a natural process, a disease that can and should be fought.

The pelvic floor muscles in women are quite weak. After 40 years, every third person experiences a problem such as urinary incontinence. This pathology cannot be ignored, and timely diagnosis allows you to prescribe effective treatment.

Reasons

Involuntary urination in older women can be caused by the following reasons:

Smoking;

Constipation;

Overweight;

Genetic predisposition;

Prolapse of the uterus;

Inflammatory processes of the bladder;

Inflammation of the appendages.

A common cause is prolapse of the pelvic walls of the vagina and the consequences of some gynecological operations. We must also not forget that the hormonal changes that occur in female body When menopause occurs, the sphincter and muscles gradually weaken.

Treatment

Treatment begins with comprehensive survey female patients.

The first stage is collecting anamnesis. The doctor must be informed about the number of births, surgical interventions, and existing diseases.

Then a gynecological examination is carried out, during which smears are taken for research. To clarify the picture, it is done ultrasound examination bladder and kidneys.

To determine the amount of urine excreted, you need to take a test using a special pad.

The pressure in the urethra and bladder is also measured.

These studies make it possible to find out the cause of urinary incontinence and develop effective method treatment.

In the initial stages, non-surgical treatment is used, which includes:

Bladder training;

Strengthening the pelvic floor muscles;

Physiotherapy.

Bladder training involves developing a urination plan. Following the plan, you need to stick to the schedule, gradually increasing the interval between trips to the toilet. It is possible to prescribe auxiliary medications. The program lasts 3 months.

Strengthening the pelvic floor muscles is effective method treatment and prevention of incontinence.

Physiotherapy strengthens muscles and increases the elasticity of ligaments. This effect is achieved due to improved blood circulation in the pelvis. The method involves the use of procedures such as microcurrent, heating, ultrasound therapy, and electromagnetic pulse.

Drug therapy involves oral administration medications, as well as introducing them into the genital cavity using a Janet syringe.

Such procedures relax the muscles and suppress the urge to urinate. The result appears only a few weeks after the start of treatment.

The specific drug and its dosage are selected individually for each patient by the attending physician.

Surgical treatment is used if other methods have not brought a positive effect. Minimally invasive methods are used more often. After surgery, the woman can return to her usual lifestyle the very next day.

Prevention

To protect yourself from urinary incontinence or avoid relapses, you should take preventive actions:

1. You cannot lift objects heavier than 5 kg, so as not to increase intra-abdominal pressure.

2. You should try to empty your bladder in a timely manner. It is extremely undesirable to endure it; it is better to go to the toilet in advance.

4. You need to stop using alcoholic drinks and tobacco products. And also try to avoid stressful situations.

Any disease is easier to treat with initial stage. Therefore, you should be attentive to your health, and if unusual symptoms occur, immediately seek qualified medical help.

Contents of the article:

Many women face the problem of involuntary loss of urine. Its quantity varies: from a few drops to the entire portion after a sudden urge. Fear that the problem will become noticeable to others prevents you from enjoying active life with family and friends.
Urinary incontinence can occur during sexual intercourse, which leads to severe emotional distress.

Women are susceptible to incontinence 2 times more often, this is explained by motherhood, changes in tissue structure during menopause against the background of hypoestrogenism. Urinary incontinence in women over 40 years of age is often stressful or mixed; after 50 years of age it is associated with the onset of menopause. In addition, multiple sclerosis leads to incontinence, neurological disorders and natural aging. Damage to the bladder muscles can cause trauma to the pelvic organs and iatrogenic injuries as a result of medical interventions.

There is no single treatment regimen that works for all types of urinary incontinence.

Stress urinary incontinence

As a result of predisposing factors, the muscles of the pelvic floor, vagina, and the ligaments that support the bladder weaken.

A change in the anatomically normal position of the bladder leads to the fact that the walls of the urethra do not close tightly, and urine can flow freely from the urethra during moments of physical stress (laughing, coughing, running, cycling, etc.).
Any increase in intra-abdominal pressure leads to loss of control over urination.

Stress urinary incontinence is characterized by increased symptoms before menstruation. During this period, the level of estrogen decreases, resulting in a decrease in muscle pressure around the urethra. The prevalence of stress urinary incontinence in women increases during menopause.

There are 3 degrees:

Mild, associated with slight loss of urine during heavy physical activity, coughing and sneezing;
medium - when running, walking, changing body position;
heavy - at rest.

There is no urge to urinate during stress incontinence.

Urgent urinary incontinence in women

This type of incontinence is a consequence of discoordinated work of the sphincters and pathological nerve impulses leading to spasms of the bladder muscles.
This type of incontinence is characterized by leakage of urine after an irresistible urge to go to the toilet. The amount of urine lost is significant.

Often the situation is provoked by the sound of pouring water. The condition is aggravated by emotional stress, taking medications with a diuretic effect, drinking coffee, and alcohol.
The normal amount of urination for women is 7 times a day, 1-2 episodes of night trips to the toilet are allowed.

Symptoms of an overactive bladder include the following:

Frequent urination more than 8 times a day, or nocturia more than 2 times;
urgency of urges;
actually, loss of urine after an urgent urge;
nocturia (urination during night sleep).

Functional urinary incontinence

This type is typical for women suffering from extragenital pathology, but without any functional problems with the bladder. Functional urinary incontinence is diagnosed in all neurological pathologies associated with dysfunction of the pelvic organs, some psychiatric diseases and all physical disabilities that prevent you from getting to the toilet on time. For example, a severe form of arthritis associated with immobility.

Overflow incontinence

An overfilled bladder and the associated leakage of a small portion of urine develops against the background of symptoms of obstruction of the lower urinary tract. Disturbance in the outflow of urine is caused by the following:

There is evidence of a good therapeutic effect after electrical stimulation.

Neuromodulation

In the absence of positive dynamics from behavioral therapy and medication, the doctor may suggest the use of neuromodulation, which affects the muscles and sacral nerves.

Initially, the result of exposure to the external InterStim device is assessed; if the reduction in unwanted symptoms occurs by 50%, implantation of the device is possible.
Contraindications: obstruction and tumor process.

An individual program is selected for each patient.

Treatment is expensive and is associated with some complications that occur with invasive techniques. The possibility of periodic replacement of the system must be considered.

Vaginal devices for stress urinary incontinence

Pessary is a rigid ring that is inserted into the vagina to normalize the anatomical position of the genitals. For some women, this helps solve the problem; the disadvantages of using pessaries include the following:

The need for daily insertion of a holding device and its sterilization;
feeling foreign body in the vagina;
the likelihood of recurrent infections;
microtraumatization.

Injections for stress urinary incontinence in women

Various fillers, such as collagen, can be injected into the bladder sphincter area to make the tissue more elastic, allowing the walls of the urethra to fit more tightly together.

The operation is performed under anesthesia and lasts about 30-40 minutes. Long-term rehabilitation is not required.

Disadvantages include the need reintroduction materials, since the body can dissolve and utilize fillers.

The effect lasts for 6-10 months. Studies are being conducted to show the effectiveness of injecting one's own muscle cells into stress urinary incontinence.

Surgeries for urinary incontinence

In case of stress incontinence after failure of conservative therapy, it is possible surgical correction. There are a sufficient number of operations that return the bladder to its normal position.

Three main ones - posterior pubic urethropexy and 2 sling operations.

Sling- tape, loop that secures the urethra. A common retropubic urethropexy is the Burch operation - suspension of the urethra using the vaginal walls. Its advantages over cystourethropecia include the following aspects:

Absence of osteitis of the pubic bones;
greater strength of the pectineal ligament than the periosteum of the pubic bones;
Traumatic denervation of the urethra is not performed.

Before the intervention, cystography is performed with and without straining and a specialized test (no leakage of urine in a vertical position when the urethra is displaced anteriorly and upward).

Fixation of the urethra with transvaginal tape (TVT) or transobturator loop- sling operations, the surgeon makes an incision behind the pubic bone or on the sides of the vagina, passes the tape under the urethra and brings the ends through the incisions and fixes them when urethra will return to normal position.

At pelvic prolapse performed more often hysterectomy.

Sling operations effective in 70% of cases, and urethropexy of the urethra using the Birch procedure in 50%. However, improvement is noted in 82% of cases.

Catheterization

For overflow incontinence, bladder catheterization is used, as needed, or a permanent catheter is installed.

Urinary incontinence in women over 50 years of age

Experts recommend against involuntary urine leakage as a side effect of menopause or aging. If desired, this pathology can be successfully corrected. With age, the likelihood of this disease increases.

Estrogen is a hormone that regulates menstrual cycle, protects the cardiovascular system and slows bone loss. It also promotes the proper functioning of the urethra and bladder. As the body naturally ages, hormone levels drop, which leads to weakening of the pelvic floor muscles. Estrogen continues to decline after menopause, which may explain urinary incontinence in women over 60 years of age.

The risk of developing urinary incontinence during menopause increases if the following occurs:

Alcohol and caffeine consumption;
chronic infections urogenital tract;
disturbance of innervation;
taking blood pressure medications with a diuretic component; other diuretics.

Besides everyone existing methods(medication, behavioral therapy, neurostimulation, surgery), improvement in condition will be expected after replacement therapy hormone therapy estrogens. It must be taken into account that intervention in hormonal background can be dangerous in a number of conditions, so the decision can only be made by a doctor after a full examination.

Even if conservative therapy did not help, and the operation is impossible for some reason, there are ways to alleviate the condition and improve the quality of life. For example, you can use absorbent materials:

Diapers;
urological pads;
special underwear for adults with urinary incontinence.

Most of the above is not visible under clothing, so there is no reason to give up an active life.

Diapers for women with urinary incontinence, they can lead to dermatitis, since urine is an aggressive environment that can cause maceration (wetting) and even ulceration. Therefore, it is recommended to change this absorbent product at least every 2.5 hours, in case of urinary dermatitis more often, or to abandon diapers for a while.

The skin in the intimate area should be washed 2-3 times a day, after which moisturizing ointments and creams should be applied. In case of redness, the skin is treated with solutions with an anti-inflammatory effect: Chlorhexidine, Dioxidine, Miramistin, etc. In case of severe inflammation, a thin layer of Baneocin cream can be applied.

Tablets for urinary incontinence in elderly women are selected taking into account the type of incontinence, the principles of treatment are standard.

Bedwetting in women (enuresis) is considered separately.