How to treat urge urinary incontinence?

Author: Lou Wenjia Peking Union Medical College Hospital

Reviewer: Zhu Lan, Chief Physician, Professor, Doctoral Supervisor, Peking Union Medical College Hospital

In my country, nearly 1/3 of women suffer from urinary incontinence, which affects their lives and physical and mental health. Urine involuntarily leaks out when you shouldn’t urinate or can’t urinate, which are all symptoms of urinary incontinence.

For example, some female friends go out shopping and have to rush to the bathroom as soon as they feel the urge to urinate. Sometimes they feel "out of control" or "wet their pants" before they even reach the door. This not only affects their mood, but also can cause urinary tract infection if the symptoms of urinary incontinence are not improved for a long time.

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However, many patients do not take urinary incontinence seriously, thinking it is a natural phenomenon of aging or postpartum recovery. But they do not know that urinary incontinence is actually a disease that can be improved through treatment.

1. What is urge urinary incontinence?

Urge incontinence refers to the involuntary leakage of urine after a sudden and strong desire to urinate. In addition to the urge to urinate, patients with urge incontinence also have symptoms of frequent urination or increased nocturia. A small number of patients may have the urge to urinate but are unable to urinate.

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The cause of urge incontinence is still unclear, but it is known that overactive bladder (a syndrome characterized by the urge to urinate) may present with symptoms of urge incontinence.

In addition, neurological diseases, urinary tract obstruction or urinary tract infection below the bladder, diabetes and other causes may cause damage to the bladder nerves, leading to urge urinary incontinence.

So, how should patients with urge urinary incontinence be treated to restore their health?

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Treatment of urge urinary incontinence

The treatment of urge urinary incontinence should follow the principle of gradual progress, and there are mainly five treatment methods.

1. Etiological treatment : that is, treatment is carried out according to the cause of urge incontinence. If the patient's urge incontinence is caused by cystitis, the cystitis should be treated first, and the symptoms of urinary incontinence will improve accordingly.

2. Behavioral therapy : including lifestyle guidance, bladder training and biofeedback therapy. (1) Lifestyle guidance: including changing bad living habits, such as drinking less alcohol and coffee, ensuring adequate sleep, etc. (2) Bladder training: by delaying urination and timing urination, the patient can consciously and actively inhibit bladder contraction and increase bladder capacity. (3) Biofeedback therapy: using biofeedback therapy equipment, with the help of the equipment, the patient can feel the bladder activity and learn self-control, thereby inhibiting bladder contraction.

3. Drug treatment : Urge urinary incontinence is treated by using drugs to reduce the internal pressure of the bladder and increase the bladder capacity.

4. Electrical stimulation therapy : transvaginal, anal, transcutaneous electrical nerve modulation therapy and magnetic stimulation therapy. Electrical stimulation therapy is effective for some patients. Patients who are ineffective with etiological treatment, behavioral therapy and drug therapy can try this method.

5. Surgical treatment : It is only suitable for severe patients. When the symptoms have seriously affected the quality of life and other methods have not improved the condition, surgical treatment can be used.

For patients with urge urinary incontinence, the treatment method should be selected in the order mentioned above. Direct surgical treatment is generally not recommended.

3. Treatment of urge incontinence, surgery is not effective

Why is surgical treatment not recommended for urge incontinence? Generally speaking, only stress urinary incontinence and mixed urinary incontinence are treated surgically. Stress urinary incontinence refers to urine leakage when the pressure on the abdomen increases, such as going up and down stairs, mopping the floor, or sneezing. Mixed urinary incontinence means that in addition to stress urinary incontinence, the patient also has symptoms of urge urinary incontinence. There is no regular pattern for the manifestation of each symptom. Sometimes the symptoms of stress urinary incontinence are more obvious, and sometimes the symptoms of urge urinary incontinence are more obvious.

Surgery for urge incontinence is not very effective, so it is not recommended. Even for mixed incontinence, the doctor will first determine whether it is mainly urge incontinence or stress incontinence based on the patient's condition.

If urge incontinence is the main problem, behavioral, drug, electrical stimulation and other treatments are used first. Even if stress incontinence is the main problem, drug treatment is usually used for a period of time. Only when it is ineffective will surgical treatment be considered.

Conclusion

Urinary incontinence not only affects the patient's quality of life and physical health, but also increases the patient's psychological pressure. Therefore, we must pay attention to the disease of urinary incontinence. If there are symptoms, you should seek medical treatment in time, cooperate with the doctor, and actively treat it, so as to get rid of the trouble of urinary incontinence as soon as possible and enjoy a happy life!