How to judge what type of urinary incontinence you belong to?

Although urinary incontinence is a common and frequently-occurring disease, the survey found that Chinese people know little about urinary incontinence. Even though many people are troubled by the problem of urinating, they still think that the failure of the "faucet" switch is only a problem of old age. I don't know that urinary incontinence is not a patent for the elderly. It is said that knowing ourselves and knowing ourselves is invincible, and only by correctly understanding the disease can we overcome the disease. Urinary incontinence can be subdivided into four categories: 1. Stress urinary incontinence II. Acute urinary incontinence Mixed urinary incontinence (stress and urgency coexist) 4. Overflow urinary incontinence Stress urinary incontinence is most common in postpartum and postmenopausal women. Patients with stress urinary incontinence generally have no urinary incontinence, but when the intra-abdominal pressure suddenly rises (such as coughing, sneezing, laughing, going upstairs or lifting heavy objects, etc.). ), urine will involuntarily flow out from the urethral orifice; In severe cases, it may occur when walking or standing upright. This kind of urinary incontinence is not accompanied by frequent urination and urgency, and the urine output of urinary incontinence is not much; Urinary incontinence is aggravated when standing, and symptoms are relieved after lying down; Many patients will also have uterine prolapse, bladder and urethra bulging and so on. Treatment of stress urinary incontinence: 1. For patients with mild urinary incontinence, behavioral therapy or drug therapy can be taken. 2. For moderate and severe patients, it is difficult to achieve the ideal effect by simple conservative treatment, and surgical treatment must be taken-tension-free vaginal middle urethral suspension. Urgency urinary incontinence is characterized by sudden uncontrollable urination and frequent urination. Such patients often need to use the bathroom, even once every half hour, and often wet the bed at night. Occasionally, I will see such a patient in the clinic: frequent urination in the middle of the night, getting up to pee almost once an hour, and not sleeping well. Sometimes I'm in a hurry and sit on the toilet before I have time to pee. Urgency urinary incontinence is mainly due to involuntary contraction of bladder, which is called overactive bladder. Under normal circumstances, the bladder will not contract automatically unless it is consciously urinated, the bladder pressure rises, and the urethral sphincter relaxes and urination is completed. But urge incontinence refers to the involuntary contraction of bladder. Once the systolic pressure of bladder is higher than the pressure of urethral sphincter, urine will flow out of urethra and leak. There are many reasons for urge urinary incontinence, including: nervous system diseases: stroke, multiple sclerosis or Parkinson's disease may all induce urge urinary incontinence. Spinal diseases: Sometimes a variety of spinal diseases can also cause the formation of urge urinary incontinence, including spinal tumors and spinal trauma, which may cause urge urinary incontinence. Diabetes: Because diabetic patients are prone to neuropathy, it is also easy to cause the problem of urge urinary incontinence. Urinary tract infection: Urinary tract infection, especially cystitis or urethritis, can also cause the problem of urgent urinary incontinence, so the doctor will check the patient's urine first to determine whether there is urethritis. Only by distinguishing the types of urinary incontinence can we prescribe the right medicine. The treatment of urge urinary incontinence is 1. For patients with mild urinary incontinence, behavioral therapy or drug therapy can be taken. 2. For moderate and severe patients, the treatment is completely different from stress urinary incontinence. For patients with poor conservative treatment effect or unbearable side effects of drugs, it is internationally recognized that sacral nerve electrical stimulation (commonly known as bladder pacemaker) has a better effect. 3. There is another surgical method called bladder enlargement. During bladder enlargement, the detrusor muscle at the top of the bladder for urination is cut off, which will weaken the muscle contraction force and improve the overactive state of the bladder. However, because this operation is irreversible, postoperative complications may include urinary leakage, persistent urinary incontinence and kidney injury, and long-term risks include bladder stones, bladder tumors and persistent urinary incontinence. It is suggested that patients who are younger and have higher requirements for quality of life should be carefully considered. Filling urinary incontinence refers to chronic urinary retention caused by urethral obstruction (urethral stricture, benign prostatic hyperplasia) and bladder contraction weakness. When the bladder is extremely full, the pressure in the bladder exceeds the resistance of the normal urethral sphincter, and urine overflows from the urethra. When the increase of urine makes the internal pressure of bladder exceed the maximum urethral pressure, even a small amount of urine will overflow involuntarily. Long-term increase of intravesical pressure will cause upper urinary tract obstruction and damage renal function. The common clinical causes are benign prostatic hyperplasia, prostate cancer and neurogenic bladder.