No shame anymore

Date :01-Nov-2019

At times, stress could make an embarrassing situation for all. Certain physical activities such as coughing, sneezing, laughing or exercises might cause an involuntary loss of urine. This involuntary loss of urine can be termed as Stress Urinary Incontinence (SUI). It is a common issue for women than in men.

Causes
People assume that SUI is mainly caused by aging and that is wrong. There are various reasons why the muscles get weak and people have SUI:

Excess weight
Coughing
Laughing
Sneezing
Lifting heavy objects
Genital trauma
Cricket ball injury
Traumatic Childbirth
Certain medicines
Injuries in urethra
Prostate surgery
Nerve injuries in the lower back
Smoking which might cause chronic coughing
Excess consumption of alcohol

Symptoms

The main symptoms of SUI are

Urinary leak on
Coughing
Laughing
Sneezing
Climbing stair case
Strenuous activities like weight lifting

Management
Most important is the severity of the problem and how much the urine leak is bothering or effecting the patient. Mild leaks which is not bothering the patient can be left alone.

The doctors would ask for medical history to determine the type of urine leak and order tests to ascertain the diagnosis .
Physical exam for abdomen and genitals
Urine sample to test urinary infections and other abnormalities
Neurological exam to identify pelvic nerve problems
Urinary stress test
Ultra sonography of the Kidney and urine bladder.

There are different types of treatment for SUI such as:
Life style changes
Life style changes could either help to eliminate or lessen SUI. Few factors to be considered under life style changes would be

Consume less fluids
Urinate more often or timely voiding to reduce the involuntary leak
Avoid strenuous activities
Eat food that contains fibre as it could help avoid constipation
Reduce weight
Avoid alcohol
Avoid food that irritates the bladder such as spicy foods, carbonated drinks, and citrus
Diabetic patients need to keep the blood sugar level under control

Pelvic floor muscle training - kegel exercises may help control involuntary loss of urine. These exercises will strengthen the muscles around the urethra. Biofeedback is used to identify and control the pelvic flo0or muscles. It involves pressure sensors or electrode stimulations to reinforce the proper muscle contractions.

Oral medications

Dulaxetin along with Darifenacin, solifenacin and Mirobegran can be used to reduce the SUI

Surgery

when other treatments and conservative measures fail, doctors would suggest surgery and those are as follows:
Anterior vaginal repair helps to restore the weak and saggy vaginal walls

TVT and TOT Trans vaginal tape or trans obturator tape surgeries. These are Urethral slings ( synthetic mesh tapes ) to support the urethra and cause coaptation of the urethra to prevent urinary leak. They are simple surgeries one or two days in the hospital. Thus they have become very popular surgeries in SUI.
Artificial urinary sphincter is usually used in men. It is a device that helps to keep involuntary loss of urine
Bulking injections help to make the area around the urethra thicker as to could help control involuntary loss of urine