Urine is produced by our kidneys. These are waste matters that need to be excreted by the body. From the kidney, trickles of urine pass on through the ureter going to the bladder. The bladder stores the urine produced by the kidneys. As more urine fills the bladder, it expands until you will feel the bladder is full and has to be excreted by urinating. From the bladder, it goes out through the urethra. The flow of urine from the bladder to the urethra is made possible because of the help of the pelvic floor muscles.
It comes to a point in our lives when we get to experience uncontrollable excretion of certain amounts of urine better known as urine incontinence. Stress incontinence is one type of urine incontinence. In fact, this is the most common type. In this condition there is uncontrollable urine output and this could be due to some physical activities such as coughing, sneezing and even laughing. Exercises such as lifting weights, running and jumping may also contribute to this condition.
This is commonly observed in women but it could also be seen in men due to other factors such as obesity, prolonged coughing because of asthma, bronchitis and smoking. More often than not, it may happen when the pelvic floor muscles are weak or when there is a problem with the urethral sphincter because it is not working properly. In this case, the sphincter is unable to stop the urine from flowing when pressure is placed on the abdominal area. Pelvic floor weakness commonly happens during childbirth and this explains why women are more prone to this type of incontinence but other factors contributing to pelvic floor weakness could also happen such as intake of medications and injury to the urethra or associated areas.
Treatment and Management
The patient is required to undergo physical examinations such as pelvic exam in women, genital exam in men and rectal examination. In women, after a pelvic examination is done, the bladder or the urethra will show that it is bulging into the vagina. Some of the tests required include pelvic ultrasound, x-rays with the application of contrast dye for the kidneys and bladder, urinalysis to verify if there is urinary tract infection or none, pad test to see how much the pad weighs before and after the exercise, cystoscopy to see the insides of the bladder. Electromyogram, on the other hand, is rarely done but if ever this is required by the doctor, it is simply to test the muscle activity in the urethra or the pelvic floor.
The following are recommended treatments: pelvic floor muscle exercises, medications, lifestyle changes and surgery. Pelvic floor muscle training helps control leakage of the urine. Medications such as anticholinergic drugs to control the overactive bladder and antimuscarinic drugs to block bladder contractions, on the other hand, will work best in patients that are categorized under mild to moderate stress incontinence. Lifestyle changes may be required, which include drinking less fluid, weight loss and avoidance of drinks and food that will irritate the bladder. Surgery is the last resort and will only be required if the exact cause has been found and is an absolute necessity.
If you are experiencing stress incontinence, do not keep it to yourself. There are ways and means of addressing this disorder appropriately to improve overall wellbeing.
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