*What is urinary incontinence (UI) in women?
-Urinary incontinence is the loss of bladder control, resulting in the accidental loss of urine.
-Some women may lose urine while running or coughing, called
"" stress incontinence. ""
-Stress incontinence results from movements that put pressure on the bladder and cause urine leakage, such as coughing, sneezing, laughing, or physical activity.
-Physical changes from pregnancy and childbirth often cause stress incontinence.
-Weakening of pelvic floor muscles can cause the bladder to move downward, pushing the bladder slightly out of the bottom of the pelvis and making it difficult for the sphincters to squeeze tightly enough.
-As a result, urine can leak during moments of physical stress.
-Stress incontinence can also occur without the bladder moving downward if the urethra wall is weak.
-Others may feel a strong, sudden need, or urgency, to urinate just before losing urine, called ""urgency incontinence. ""
-Many women experience both symptoms, called ""mixed incontinence""
or have outside factors, such as difficulty getting to a standing position or only being able to walk slowly, that prevent them from getting to a toilet on time.
-UI can be slightly bothersome or totally debilitating.
- For some women, the chance of embarrassment keeps them from enjoying many physical activities, including exercising.
-People who are inactive are more likely to be obese.
-Obesity increases a person’s chances of developing diabetes and other related health problems. -UI can also cause emotional distress. However, UI often can be controlled.
*medical treatment ..."العلاج الطبي"
1-pharmacological ..."دوائيا"
a-to relax detrusor muscle...use anti cholinergic drugs
Ex:-
-uripan syp...contains "oxybutynin chloride "...5mg/8hr
-taltoradine or detrusitol tab...contains "tolterodine 2mg"
(One tab at bed time...قرص مرة واحدة مساء وقت النوم)
-genurin tab...contains "flavoxate " ...200 mg/8hr
(One tab 3 times daily...قرص ثلاث مرات يوميا)
b-to contract urinary bladder sphincter...use alpha agonist drug
Ex:-
-midodrine tab...contains"midodrine HCl "...2.5mg/8hr
(One tablet 3 times daily...قرص ثلاث مرات يوميا"
c-hormonal replacement therapy
-this indicated if urinary incontinence in women after menopause
"العلاج بالهرمونات يستخدم في حالة حدوث سلس البول بعد سن اليأس "انقطاع الطمث""
2-interventional treatment:-
◆◆Non surgical
★biofeed back:-
-bio feed back uses measuring electronic devices to help woman to become aware of her body's functioning .
-by using electrical stimulation to track when her bladder and urethral muscle contract,woman can gain control over these muscles .
-bio feed back can also supplement pelvic muscle excersises.
★neuromodulation:-
-by stimulation of nerves to the bladder leaving the spine .....the FDA has approved a device called "interstim" surgically implanted for this purpose .
-although neuromodulation can be effective ...it is not for every one
★vaginal devices :-
-for stress incontinence caused by weakness of pelvic muscles that hold the bladder in place and hold urine inside .
-apessary is a stiff ring that a doctor inserts into the vagina , where it presses against the wall of the vagina and the nearby urethra .
-the pressure helps reposition the urethra , leading to less stress leakage .
★injection of bulking agents as collagen and carbon spheres:-
-for injection near the urinary sphincter .
-into tissues around the bladder neck and urethra to make the tissues thicker and close the bladder opening to reduce stress incontinence.
★catheterization
◆◆Surgical
-transvaginal tapes TVT
-trans obturator slings TOT
3-behavioral treatment:-
-ممارسة التدريبات الرياضية
*تمارين عضلات قاع الحوض "kegel excersise"
(تعتمد هذه التمارين على تدريب العضلات التي تبدأ وتوقف تدفق البول)
*استخدام الأقماع المهبلية
(هي أقماع صغيرة من البلاستيك على شكل مخروطي تضعها المرأة في المهبل عند القيام بتمارين الحوض حيث تساعد على زيادة انقباضات عضلات قاع الحوض.
*تدريب المثانة
(عن طريق افراغ المثانة في أوقات معينة مع الزيادة التدريجية في الوقت بين الفواصل الزمنية )
*تجنبي السوائل المدرة للبول مثل اللبن والشاي والكحول
*اتبعي نظام غذائي لإنقاص الوزن
Imp.note...معلومة مهمة...
-wearing absorbent undergarments , or diapers is unfortunate ...because diapering can lead to diminished self-esteem , as well as skin irritation and sores
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