Urinary leakage quickly becomes a handicap if it is not discussed with your doctor. This makes it possible to determine what type of incontinence one suffers from (stress incontinence or by emergency room) and to set up a suitable solution. Perineum rehabilitation, medication, surgery: update on treatments.
Urinary incontinence is not a disease as such, but the symptom of a physical, neurological or psychological disorder . It is characterized by involuntary leakage of urine in the form of drops or spray. As soon as urinary leakage becomes persistent and bothersome, it is essential to consult a general practitioner, a gynecologist or a urologist in order to put in place the appropriate solutions.
Three types of urinary incontinence
We distinguish :
the urinary incontinence : leakage occur during exercise: physical activity, coughing or sneezing, laughing, carrying loads ...
Urinary incontinence due to urgency ( overactive bladder ), which is characterized by the impossibility of retaining a pressing urge to urinate, frequently associated with the presence of urgent needs to urinate (with or without leakage).
the mixed urinary incontinence .
Establish the diagnosis of incontinence
The diagnosis is first clinical: questioning the patient to identify the circumstances in which the leaks occur, then clinical examination. In particular, we perform an anatomical examination of the small pelvis to verify that there is no malformation or prolapse (organ descent). We are also trying to determine a possible vaginal dryness testifying to an estrogen deficiency.
Different quick and simple tests can be prescribed to determine the causes of incontinence .
A urinalysis is requested, looking for a possible infectious origin.
It is also recommended to keep a voiding catalog , i.e. to note the time and volume (with a measuring cup) of voiding for two days.
Then the urologist performs further examinations. He can check the emptying of the bladder by ultrasound .
A urodynamic workup is prescribed before a surgical solution: this involves checking the pressure in the bladder and the urethra using a probe.
Rehabilitation of the perineum as a first treatment
Perineal rehabilitation is always offered as the first treatment for incontinence. It consists, with the help of the physiotherapist, in remusculating his perineum . It also includes behavioral methods aimed at relearning, as the case may be, urinating regularly (so as not to end up with a bladder that "overflows") or conversely at spacing your urination (in case of too frequent urges to urinate) .
Perineal rehabilitation is effective on all types of incontinence.
Medicines to calm overactive bladder
Drug treatment is available only in case of incontinence by urgency: these drugs of the class of anticholinergics allow to calm the hypersensitivity of the bladder, but its side effects (dry mouth, constipation ...) sometimes make it difficult to bear. A new drug from the class of B3-agonists , without the side effects of anticholinergics, is available today and can be used in certain cases.
In case of vaginal dryness , a prescription of vaginal estrogens is generally recommended, in combination or not with hormone treatment if the woman is menopausal .
The use of absorbent protections
Several types of products provide comfort to maintain daily activities.
The majority of incontinence treatment in Bangalore people go to absorbent protections , which are available according to everyone's expectations: briefs, complete diapers, shells for men ... They are suitable for nights, and the materials are close to the textile sensation. However, they are not reimbursed by Social Security.
Men can wear a penis case . It is a kind of condom that is connected to a collection bag. Well fixed, it does not cause urine leaks or odors. Significant advantage, penis cases are reimbursed by Social Security.
In addition to absorbent protections, women with mild to moderate incontinence can use a specific tampon to prevent urinary leakage for a few hours, for example, the time of a physical activity or an outing. This product is reimbursed by Social Security.
Surgery of last resort for urinary incontinence
Surgery, when possible, is a solution in the event of perineal rehabilitation failure. But it is only offered to people who feel they can no longer bear their urinary incontinence. "urine leak treatment in Bangalore only operate on people who are embarrassed and motivated," says urologist Dr, Praveen Joshi.
Four surgical solutions are possible depending on the causes and type of incontinence.
The insertion of a sub-urethral strip is a benign procedure which consists in placing a strip under the urethra to keep it in good position.
Two adjustable peri-urethral balloons , filled with physiological saline, can be placed on either side of the urethra: by exerting pressure, they replace the function of the sphincter.
The installation of an artificial urinary system is a heavier operation in the event of a sphincter insufficiency, that is to say of the muscles which close the channel of the urethra.
The neuromodulation of the sacral roots is offered to people with incontinence urge incontinence and why the medication would not work. Dr. Praveen joshi defines it as a "bladder pacemaker" acting on the nerves of the bladder.
Another recent solution: the injection of botulinum toxin into the bladder, but the effect is transient (a few months). The procedure is performed under light anesthesia by the endoscopic route.
- Three types of urinary incontinence
- Establish the diagnosis of incontinence
- Rehabilitation of the perineum as a first treatment
- Medicines to calm overactive bladder
- The use of absorbent protections
- Surgery of last resort for urinary incontinence
Urinary incontinence is not a disease as such, but the symptom of a physical, neurological or psychological disorder . It is characterized by involuntary leakage of urine in the form of drops or spray. As soon as urinary leakage becomes persistent and bothersome, it is essential to consult a general practitioner, a gynecologist or a urologist in order to put in place the appropriate solutions.
Three types of urinary incontinence
We distinguish :
the urinary incontinence : leakage occur during exercise: physical activity, coughing or sneezing, laughing, carrying loads ...
Urinary incontinence due to urgency ( overactive bladder ), which is characterized by the impossibility of retaining a pressing urge to urinate, frequently associated with the presence of urgent needs to urinate (with or without leakage).
the mixed urinary incontinence .
Establish the diagnosis of incontinence
The diagnosis is first clinical: questioning the patient to identify the circumstances in which the leaks occur, then clinical examination. In particular, we perform an anatomical examination of the small pelvis to verify that there is no malformation or prolapse (organ descent). We are also trying to determine a possible vaginal dryness testifying to an estrogen deficiency.
Different quick and simple tests can be prescribed to determine the causes of incontinence .
A urinalysis is requested, looking for a possible infectious origin.
It is also recommended to keep a voiding catalog , i.e. to note the time and volume (with a measuring cup) of voiding for two days.
Then the urologist performs further examinations. He can check the emptying of the bladder by ultrasound .
A urodynamic workup is prescribed before a surgical solution: this involves checking the pressure in the bladder and the urethra using a probe.
Rehabilitation of the perineum as a first treatment
Perineal rehabilitation is always offered as the first treatment for incontinence. It consists, with the help of the physiotherapist, in remusculating his perineum . It also includes behavioral methods aimed at relearning, as the case may be, urinating regularly (so as not to end up with a bladder that "overflows") or conversely at spacing your urination (in case of too frequent urges to urinate) .
Perineal rehabilitation is effective on all types of incontinence.
Medicines to calm overactive bladder
Drug treatment is available only in case of incontinence by urgency: these drugs of the class of anticholinergics allow to calm the hypersensitivity of the bladder, but its side effects (dry mouth, constipation ...) sometimes make it difficult to bear. A new drug from the class of B3-agonists , without the side effects of anticholinergics, is available today and can be used in certain cases.
In case of vaginal dryness , a prescription of vaginal estrogens is generally recommended, in combination or not with hormone treatment if the woman is menopausal .
The use of absorbent protections
Several types of products provide comfort to maintain daily activities.
The majority of incontinence treatment in Bangalore people go to absorbent protections , which are available according to everyone's expectations: briefs, complete diapers, shells for men ... They are suitable for nights, and the materials are close to the textile sensation. However, they are not reimbursed by Social Security.
Men can wear a penis case . It is a kind of condom that is connected to a collection bag. Well fixed, it does not cause urine leaks or odors. Significant advantage, penis cases are reimbursed by Social Security.
In addition to absorbent protections, women with mild to moderate incontinence can use a specific tampon to prevent urinary leakage for a few hours, for example, the time of a physical activity or an outing. This product is reimbursed by Social Security.
Surgery of last resort for urinary incontinence
Surgery, when possible, is a solution in the event of perineal rehabilitation failure. But it is only offered to people who feel they can no longer bear their urinary incontinence. "urine leak treatment in Bangalore only operate on people who are embarrassed and motivated," says urologist Dr, Praveen Joshi.
Four surgical solutions are possible depending on the causes and type of incontinence.
The insertion of a sub-urethral strip is a benign procedure which consists in placing a strip under the urethra to keep it in good position.
Two adjustable peri-urethral balloons , filled with physiological saline, can be placed on either side of the urethra: by exerting pressure, they replace the function of the sphincter.
The installation of an artificial urinary system is a heavier operation in the event of a sphincter insufficiency, that is to say of the muscles which close the channel of the urethra.
The neuromodulation of the sacral roots is offered to people with incontinence urge incontinence and why the medication would not work. Dr. Praveen joshi defines it as a "bladder pacemaker" acting on the nerves of the bladder.
Another recent solution: the injection of botulinum toxin into the bladder, but the effect is transient (a few months). The procedure is performed under light anesthesia by the endoscopic route.
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