Urinary consistence is seen widely in the female, after pregnancy, child birth and during menopause for different reasons. Female is double vulnerable to the leakage of urine than that of the male. Most of the time the causes for the male and female urinary consistency, are the same. the bladder alignment of the female pelvis makes the condition vulnerable.
At micro level the bladder function is controlled locally by spinal cord and micturition reflex. And at macro level, it is controlled by the brain. Brain guides the individuals the right time and place to urinate. These centers of the brain are affected usually by brain tumor, Alzheimer’s, Stroke and Parinsonism. So, urination may happen right after the female gets the urge. Sometimes nerves of the spinal cord carry the sensation of the fullness in the bladder to brain. Then the brain instructs to find the washroom to pass the urine. Brain also sends the signals to the opening of the opening to keep closed, until convenience place is found. But if the spinal cord injured and nerves cut, there will be disconnection between the brain and bladder. So, when a person gets the urge, urination is done immediately. This condition is also called as urge incontinence.
Sometimes bladder will become overactive, when the spinal cord is injured. It results in a little urine causing the bladder reflex contraction and results in the contraction and also expulsion of urine in small amounts and is done with more frequency. Such condition is termed as overactive bladder. There are also other causes like diabetes, vaginal delivery for the urinary incontinence.
Urinary incontinence is usually diagnosed by the following methods.
- Bladder stress test – The test is done by vigorous coughing and the loss of urine is watched at the urinary opening.
- Maintaining a diary – Noting the number of times, the candidate has to go to washroom for relief and it acts as a good indicator.
- Ultrasound – The test creates images of bladder, ureter, urethra and kidney through the sound waves, so that the images can show the compressions or abnormalities in any of them.
- Urodynamics – It makes uses of several techniques for measuring the bladder pressure along with the urine flow.
- Cystoscopy – A thin tube, which consists of a camera is inserted in the urethra to see what is happening inside the bladder and urehra.
- Urine culture and urinanalysis – Urine is tested for urinary stones, infection or relevant causes in the laboratory.
- Behavioral Modification
Behavioral modification involves timed voiding and bladder training. Timed voiding is done by emptying the bladder at specific intervals regularly. Intake of fluid is adjusted according to the times of bedtime and also before going out, so that the accidental urinary incontinence can be avoided during outing and on the bed. This method works for the candidates, who have the urinary incontinence problem, because of the overflow incontinence or bladder mechanical compression.
- Vaginal Devices
Pessaries devices are used in the form of stiff ring for the urinary incontinence problem. It is inserted by either doctor or nurse. The device is inserted into the vagina to press against the vagina walls and also the surrounding of urethra. The pressure keeps the urethra to reposition so that the less stress leakage can be resulted. After the pessary is inserted, regular visits are to be done to the doctor to ensure the urinary tract infections are not affected.
Some medications are given to the candidate to relax the bladder and also its surrounding muscles so that the full emptying of bladder can be achieved. Anticholinergics can be used to relieve the muscle spasm of the bladder so that the sudden bladder contractions are prevented.
Neurostimulation is done for the nerves that come from the spinal cord and move towards the bladder. The nerve signals can be well modulated to the bladder so that the voiding can be controlled.
- Kegal Exercises
Kegal exercises are useful to strengthen the pelvic floor muscles, so that the sphincter muscles are kept tight so that the outlet of the bladder will be closed while strenuous activities are performed. Pelvic muscles are to be closed and count of 3 has to be done. Then relax again for the count of 3. Do the same to repeat, however overdoing is not suggested. 10 repeats of 3 sets work better. Biofeedback can make it possible. It helps for the candidates, who have stress incontinence.
- Surgery or Stress Incontinence
After the childbirth, the bladder is moved from its position, for some of the women. Different surgical procedures can be performed to keep the bladder back to its position. There are three kinds of surgeries performed to treat this problem. the first one is retropubic suspension and the other two kinds are sling procedures.
- Retropubic Suspension
The surgery involves supporting the neck of the bladder using sutures or surgical threads. Burch procedure is one of the most commonly preferred retropubic suspension procedure. The procedure is performed by making an incision into the abdomen just below the naval for a few inches. The threads are then secured to the strong ligaments placed in the pelvis, so that the urethral sphincter is supported. This procedure is usually done following another procedure, like hysterectomy.
Cost of Female Urinary Incontinence Treatment
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