Diagnosis and treatment of female urinary incontinence

According to statistics, the probability of urinary incontinence in women is much higher than that in men, especially for women who have given birth, so women should be prepared to prevent such problems. But what should we do once urinary incontinence occurs? What are the methods for diagnosing and treating female urinary incontinence? Today we will focus on recommending several methods for diagnosing and treating female urinary incontinence.

The diagnosis is confirmed based on the cause, clinical manifestations, and laboratory tests.

1. Treatment

1. Large amounts of residual urine

It can cause stress incontinence or overflow incontinence. The principle of treatment for this type of urinary incontinence is to use surgery (bladder neck or external urethral sphincter incision) to reduce urethral resistance to reduce residual urine.

2. Detrusor hyperreflexia or unstable bladder

It can cause urge or reflex incontinence and sometimes cough urge incontinence. The principle of treatment is to inhibit the uninhibited contractions of the bladder with drugs (such as verapamil), sacral nerve blocks, sacral nerve surgery or bladder nerve stripping.

For this type of patient with residual urine, the principle of treatment is to increase urethral resistance through drugs or surgery. Patients with non-resistance urinary incontinence may be treated with an artificial urinary sphincter device, urethral lengthening, urethral clamps (in women), or penile clamps.

Treatment of urinary incontinence

1. PFME combined with biofeedback therapy

Biofeedback or palpation can help determine whether the patient's muscle contractions are correct. In women, feedback can be obtained by placing small electrodes around the anus or by using electrodes inserted into the vagina. The application of biofeedback technology allows patients to immediately feel the output of their muscles during training.

Based on information from previous literature, PFME combined with biofeedback is less effective than PFME alone. However, PFME combined with biofeedback therapy may be an effective and acceptable treatment option.

A useful treatment strategy is to combine biofeedback therapy with the initiation of PFME training in patients who have difficulty understanding how to contract or are unable to contract their pelvic floor muscles.

Physical therapists can also use electrical stimulation therapy to reduce the incidence of urinary incontinence. The purpose of electrical stimulation is to increase muscle size, normalize reflex activity in the lower urinary tract, and improve circulation in the muscles and capillary system. Stimulation of the pudendal nerve can improve urethral closure by activating the pelvic floor muscles.

A recent meta-analysis showed that in the case of improvement in incontinence symptoms, there was no significant difference between sham stimulation and PFME.

In comparison, the therapeutic effect of electrical stimulation is almost the same. However, in patients who are initially unable to voluntarily contract their pelvic floor muscles, electrical stimulation may be the first choice for treatment.