Sneezing, coughing, laughing, these are the most ordinary moments in life, but for some women, the face is full of "embarrassment".
Because every time they do such a move, they will involuntarily leak some urine out.
Recently, Ms. Wang, a 57-year-old woman in Nanjing, went to the hospital for 7 years because of urinary leakage, and the doctor diagnosed her with pelvic floor dysfunction.
Women like Ms. Wang are not a minority, and according to statistics, the incidence of stress urinary incontinence in adult chinese women is as high as 18.9%.
That is, 19 out of every 100 adult women have a "cough and leak urine". In the 50-59 age group, the incidence is as high as 28% [1].
People who have experienced holding urine know that when the urine is held in a hurry, a little attention may "leak urine".
But what we want to talk about today is not a temporary leakage of urine, but often when coughing, laughing and other actions with increased abdominal pressure, which is called "stress urinary incontinence" in medicine.
Just like the faucet that is not tightly closed all year round, ticking, you need to take the basin; many women can only be accompanied by aunt towels and even diapers all year round.
Laughing, coughing, running and jumping, walking fast all have to be careful, and some people are even so serious that they will urinate incontinence when they lie in bed and turn over.
Dare not go out, do not dare to interact with others, so that some people who were originally very cheerful have gradually appeared anxiety, depression, depression and other bad emotions.
Therefore, stress urinary incontinence is also called "social cancer", which is one of the diseases that seriously affect women's social activities.
Women with strong traditional concepts will find this disease difficult to talk about, so many patients choose to endure in silence, afraid of being ridiculed.
Some people even think that this is a "natural phenomenon" caused by giving birth and aging, and they don't know that this is a disease and can be cured.
Therefore, Zhimei would like to tell you that women who are plagued by stress urinary incontinence, leakage of urine is very common, can also be cured, do not have to feel ashamed, hurry to the regular hospital to seek the help of doctors!
Stress urinary incontinence is one of the most common pelvic floor dysfunction disorders.
The pelvic floor muscle is at the bottom of the pelvis, and it acts like a hammock that firmly holds your urethra, bladder, vagina, uterus, rectum, etc., providing them with support.
（来源：Continence Foundation of Australia）
There are three major risk factors for stress urinary incontinence – pregnancy and childbirth, obesity, and aging [2].
When the pressure of the pelvic floor hammock increases to a certain extent, the pelvic floor muscle around the urethral opening loses its elasticity, just like the faucet slip wire, and the water pipe is not closed tightly.
（来源：Continence Foundation of Australia）
In addition, aging is also a major risk factor. As age increases, coupled with a sharp decline in estrogen after menopause, the pelvic floor muscles become thinner and less elastic.
In addition, sneezing, coughing, and laughing can cause our abdominal pressure (air pressure in the abdomen) to increase.
Although these factors are not a direct cause of pelvic floor muscle relaxation, if it is a chronic disease (such as chronic bronchitis) caused by a prolonged cough, it may also increase abdominal pressure for a long time and destroy the elasticity of the pelvic floor muscles.
If you frequently "leak urine" and suspect that you have stress urinary incontinence, you can test yourself in two ways [3,4]:
Stress testing
Stand up when you have a desire to urinate, cough vigorously 8 to 10 times, see if there is urine leaking, if there is, indicating the presence of pressure urinary incontinence.
Urine pad test
Drink 500ml of boiled water first, put a dry urine pad (sanitary napkin or diaper) in your underwear, and do activities such as climbing, sitting and standing up, coughing, and running in place.
If urine is excreted and the pad adds 2 grams of weight or greater, there is stress urinary incontinence.
How do I know how serious my condition is?
Weight gain of less than 5 grams is mild, 5 to 10 grams is moderate, and above 10 grams is severe.
1. Pelvic floor rehabilitation training
We can increase the strength of the pelvic floor muscle groups through exercise, which is also known as the "Kegel movement".
Here's how:
Contract the vagina and anus, just like holding urine, maintain for 3 to 5 seconds and then relax, relax for 2 to 6 seconds and repeat the action just now.
Do it for 15 to 30 minutes continuously, repeat 3 times a day or do it 150 to 200 times a day.
Exercise is not a day's work, this method focuses on persistence. Insist on training for 3 months to more than half a year to see obvious results.
If the pelvic floor is seriously damaged after childbirth, the pelvic floor muscle function can be restored by electrical stimulation and biofeedback, and the effect will be better with active pelvic floor muscle training.
2. Surgical reinforcement of the pelvic floor
For patients who do not work well or have severe symptoms, doctors may recommend surgery.
The specific surgical method needs to be evaluated by the doctor according to the physical condition.
In short, leakage of urine is a common symptom of women, pelvic floor disease can be prevented and treated, do not tolerate symptoms, timely medical treatment is right!
Reviewer
Li Yanfeng | Deputy Chief Physician of Department of Urology, Dongzhimen Hospital, Beijing University of Chinese Medicine
bibliography
Gynecologic Pelvic Floor Group, Obstetrics and Gynecology Branch of Chinese Medical Association. Guidelines for the diagnosis and treatment of stress urinary incontinence in women (2017)[J]. Chinese Journal of Obstetrics and Gynecology, 2017(5).
[2] Arshiya S, Noor L, Rangaswamy PA and Sundari T. Etiology, Risk Factors and Pathophysiology of Stress Urinary Incontinence: A Review.Int. Res. J. Biological Sci. Vol. 4(6), 75-82, June (2015)
[3] Price D.M. and Noblett K., Comparison of the cough stress test and 24-h pad test in the assessment of stress urinary incontinence, Int. Urogynecol. J., 23(4), 429-33 (2012)
[4] Cristine Homsi, Kari Bo. The Pad Test for urinary incontinence in women. March 2015. Journal of Physiotherapy 61(2)
DOI:10.1016/j.jphys.2014.12.001
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