Causes and prevention of stress urinary incontinence

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Definition, symptoms and signsStress urinary incontinence (stress urinary, incontinence, SUI) refers to the involuntary urine from the ureth


Definition, symptoms and signs

Stress urinary incontinence (stress urinary, incontinence, SUI) refers to the involuntary urine from the urethra leakage appeared sneezing and coughing or exercise abdominal pressure increased.

Symptoms such as cough, sneezing, laughing and other abdominal pressure increased involuntary urine leakage. A sign is an increase in intra-abdominal pressure, can be observed in involuntary urine from the urethra. Urodynamic examination showed cystometry, an increase in intra-abdominal pressure and detrusor stability under the condition of good appearance of involuntary leakage of urine

Two, related factors:

1, age: with age, the prevalence of female urinary incontinence increased gradually, the high incidence age of 45 ~ 55 years old. The correlation between age and urinary incontinence may be related to pelvic floor relaxation, decreased estrogen and degenerative changes of sphincter of urethra. Some common diseases, such as chronic lung disease, diabetes, can also promote the development of urinary incontinence. However, the incidence of stress urinary incontinence in elderly people is slowing down, which may be related to the change of lifestyle, such as the decrease of daily activities.

2, the number of birth: birth, first birth age, mode of production, the size of the fetus during pregnancy and the incidence of urinary incontinence and the occurrence of postpartum urinary incontinence has significant correlation, parity with urinary incontinence were positively correlated to the family; the first child at the age of 20 ~ 34 year old woman, the urinary incontinence the occurrence and fertility related degree is higher than other age groups; reproductive age is too large, the occurrence of urinary incontinence is more likely than women; vaginal delivery cesarean section women more prone to urinary incontinence; cesarean section in women than childless women had urinary incontinence risk to support the use of forceps; suction, midwifery and fetal oxytocin to accelerate the birth process also increased the likelihood of urinary incontinence; large weight fetal mother incontinence risk is big.

3, pelvic organ prolapse: pelvic organ prolapse (pelvic organ prolapse, POP) and stress urinary incontinence seriously affect the health and quality of life of elderly women. Stress urinary incontinence and pelvic organ prolapse are closely related. Pelvic organ prolapse patients with pelvic floor tissue smooth muscle fiber thinning, disorder, connective tissue fibrosis and muscle fiber atrophy may be related to the occurrence of stress urinary incontinence.

4, obesity: obese women have a significantly increased risk of stress urinary incontinence, weight loss can reduce the incidence of urinary incontinence.

5, race and genetic factors: genetic factors and stress urinary incontinence has a clear correlation. The prevalence of stress urinary incontinence was significantly correlated with the prevalence of immediate family members. The prevalence of white female urinary incontinence was higher than that of black women.

Three. Possible risk factors

  1, estrogen: estrogen has long been considered to be associated with female stress urinary incontinence. However, the recent data on the role of estrogen questioned, that the level of estrogen and the prevalence of stress urinary incontinence no correlation. Some scholars believe that estrogen replacement therapy may increase the symptoms of urinary incontinence.

2, hysterectomy: hysterectomy, such as the occurrence of stress urinary incontinence, generally in the six months to one year after surgery. Surgical technique and surgical resection may be related to the occurrence of urinary incontinence. However, there is not enough evidence to confirm that there is a certain correlation between hysterectomy and the occurrence of stress urinary incontinence.

3. Smoking: the correlation between smoking and stress urinary incontinence. Data show that the proportion of smokers with urinary incontinence is higher than that of non-smokers, which may be related to the decrease of smoking induced chronic cough and collagen fiber synthesis. Data also suggest that smoking has nothing to do with urinary incontinence.

4, physical activity: high intensity physical exercise may induce or aggravate urinary incontinence, but there is still lack of evidence of evidence-based medicine.

Other possible factors include constipation, bowel dysfunction, caffeine intake, and chronic cough.

Four, pre   prevention

1, universal education

Stress urinary incontinence is a high incidence of women, first of all should improve public awareness, increase the understanding and understanding of the disease, early detection, early treatment, its impact on the quality of life of patients to a minimum. Medical staff should further improve the awareness of the disease, extensive publicity and improve the level of diagnosis and treatment.

For patients with stress urinary incontinence, should also pay attention to psychological counseling to patients and their families that the disease condition and main harm, relieve their psychological pressure.

2, avoid risk factors

According to the common risk factors of urinary incontinence, corresponding preventive measures were taken. For urinary incontinence history, obesity, smoking, high-intensity physical exercise and many family history in the family, such as urinary incontinence, should evaluate possible correlation between living habits and urinary incontinence, and accordingly reduce exposure of susceptible factors.

Pelvic floor muscle training during and after pregnancy (PFMT).

Significance: the pelvic floor muscle training can effectively reduce the incidence and severity of stress urinary incontinence.

Timing: 20 weeks from the beginning of pregnancy to postpartum between 6 months.

Methods: 28 or more times a day, pelvic floor muscle contraction, the best training under the guidance of the doctor. Each time, including 2~6 seconds contraction / 2 ~ 6 seconds diastolic * 10 ~ 15 times.

3, selective uterine incision

Selective cesarean section can be used as one of the methods to prevent urinary incontinence, which can prevent and reduce the occurrence of stress urinary incontinence. However, the choice of cesarean section, we should also take into account the social, psychological and economic factors


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