Introduction to the causes and treatment of urinary incontinence in women after normal childbirth

Introduce to you the causes and treatments of urinary incontinence in women after normal delivery. Why does women suffer from urinary incontinence after giving birth naturally? Many women suffer from urinary incontinence, with urine leaking out whenever they cough, sneeze, laugh, lift heavy objects, run, etc. However, due to psychological reasons, many women are unwilling to tell others and instead endure it silently. Here are some of the causes and treatments for urinary incontinence in women after childbirth.

Women are more likely to suffer from urinary incontinence after giving birth. Both men and women may experience the uncomfortable symptoms of bladder relaxation, commonly known as "urinary incontinence", as they age. Such unspeakable secrets torment many people. Some people cannot ride on a bumpy bus because they will feel the urge to urinate; some people cannot laugh because they will suffer from urinary incontinence when they laugh; in the end, they may even feel the urge to urinate when walking. Because of its long-term impact on patients' quality of life and serious influence on their mental health, urinary incontinence is also called "non-lethal social cancer."

Western medicine view: "Sling" insertion can correct urinary incontinence

Interview expert: Wei Zhongqing, Director of Urology Department, Second Affiliated Hospital of Nanjing Medical University

Patients with urinary incontinence seen in the outpatient clinic generally have one thing in common: they go to the toilet frequently, are afraid to drink water, and become increasingly unconfident when socializing. However, patients generally have a weak awareness of seeking treatment, are ashamed to talk about it, or think it is unimportant, so the actual rate of seeking treatment for this disease is very low.

In terms of classification, urinary incontinence can be divided into three types: stress urinary incontinence, urge urinary incontinence and functional urinary incontinence, among which stress urinary incontinence is the most common. Moreover, among patients with urinary incontinence, female patients account for a large proportion. Data surveys show that the prevalence of urinary incontinence among women in my country is 31%, but only 7% of them go to the hospital for treatment.

Why are women more prone to urinary incontinence? It turned out that pelvic floor dysfunction was to blame. Female pelvic floor dysfunction, also known as pelvic floor defect or relaxation of pelvic floor support tissue, is caused by weak pelvic floor support due to various reasons, which in turn leads to pelvic organ displacement and causes abnormal position and function of other pelvic organs. Manifestations include lower urinary tract dysfunction, organ prolapse, sexual dysfunction, abnormal defecation and pelvic pain. Among them, lower urinary tract dysfunction mainly includes urinary incontinence, frequent urination, urgency, nocturia, delayed urination, interruption, straining, feeling of incomplete urination, and urinary retention. Women have to go through a series of processes including pregnancy and childbirth, during which it is easy for the pelvic floor muscles and nerves to be damaged, resulting in weakened control over the urethra. In the future, when the abdominal pressure suddenly increases, it will be more likely to experience "urinary incontinence".

In recent years, foreign scholars have introduced a new mid-urethral "sling" (TVT, TVTO) surgical procedure. The sling material used is an artificial synthetic product. Only a very small incision is made on the anterior wall of the vagina and the pubic bone to insert the sling to lift the patient's relaxed urethra, thereby correcting the patient's incontinence problem to the greatest extent. Whether to undergo surgery depends on the degree of distress of the patient. Usually, the patient will receive rehabilitation treatment first, and then undergo surgery if it is ineffective. However, if patients with mild to moderate urinary incontinence feel very distressed, surgery can also be an option.

Patients with severe urinary incontinence are advised to go to the hospital to receive a series of comprehensive treatments such as pelvic floor rehabilitation devices to assist pelvic floor muscle training, pelvic floor electromyography therapy, biofeedback therapy, etc. Two rehabilitation exercises are recommended:

1. Pelvic floor muscle exercises. It refers to the patient's conscious and autonomous contraction and exercise of the pelvic floor muscles, mainly the levator ani muscles, in order to improve the ability to control urine. Type I muscle exercise: slowly contract the vagina and anus to maximum force and last for at least 5-10 seconds, slowly relax, last for 5-10 seconds, repeat for 10-15 minutes, or about 100-200 times a day (can be performed in several times); Type II muscle exercise: quickly contract the vagina and anus to maximum force and then relax immediately, continuously contract - relax 3-5 times, then relax again, for 10-15 minutes.

2. Diaphragm training. Inhale and relax your abdomen, breathe naturally 2-3 times; slowly and forcefully contract your abdomen and exhale; hold your breath without moving your abdomen; continue to contract your abdomen, slowly expand your chest and lift your diaphragm; hold your breath and contract your pelvic floor muscles; exhale slowly; this can be repeated many times, 15-30 minutes a day; note that the breath-holding time depends on your personal physical condition, generally 2-3 seconds. People with cardiovascular and cerebrovascular diseases should not hold their breath excessively.

TCM perspective: Acupuncture can relieve urinary incontinence symptoms

Interview expert: Lu Jin, Director of the Acupuncture Department of Nanjing Traditional Chinese Medicine Hospital

The so-called heavy urge to urinate and urinary incontinence both fall into the category of bladder irritation, which is related to aging. Because the bladder sphincter relaxes, the automatic recovery process is a bit slower than that of young people; it may also be that the patient's kidney function is weakened, resulting in deficiency.

Traditional Chinese medicine believes that "incontinence is caused by kidney deficiency, and the kidney controls water, and its qi flows downward to the yin. Kidney deficiency causes coldness in the lower part of the body, which cannot warm the water, and therefore incontinence occurs." Therefore, although the disease is located in the bladder, the pathogenesis is attributed to kidney yang deficiency and loss of firmness. "After the age of 40, yin qi is halved," and therefore urinary incontinence is common in middle-aged and elderly people. It is what people often call old age, physical weakness, and insufficient qi, and if the kidney qi is insufficient.

Patients with urinary incontinence, bladder irritation and other discomforts can try acupuncture treatment. Traditional acupuncture mainly combines disease differentiation with syndrome differentiation. Through acupuncture, acupuncture is performed on the acupoints of the bladder meridian in the lumbar sacral region and the kidney meridian in the lower abdomen, which can replenish kidney qi, strengthen the kidney and consolidate the foundation, and replenish qi and consolidate the body. On the other hand, considering that the elderly are old and weak and their nerve function recovers slowly, Chinese medicine emphasizes tonification and purgation, that is, through acupuncture intervention, the damaged nerves can be stimulated to relieve symptoms. However, acupuncture treatment varies from person to person. It combines the symptoms and characteristics of different people and selects acupoints based on syndrome differentiation. Many people can feel the urge to urinate less and the frequency of urination lessened after one or two times. Generally, after a course of 10 times, the symptoms will improve, but some people still need a period of consolidation treatment. In addition, it is necessary to avoid stimulation from mental factors. Many people will suffer from stress-induced bladder irritation, which is not particularly beneficial for treatment.

The above will introduce to you the causes and treatments of urinary incontinence in women after normal delivery. However, many women who already have severe urinary incontinence after giving birth naturally do not pay enough attention to it, rarely see a doctor, let alone seek treatment. Urinary incontinence is very common among women. As long as the diagnosis is clear and the treatment is appropriate, urinary incontinence is a disease that can be completely cured. I hope you can go to the hospital in time and recover soon.