Urinary incontinence during sexual intercourse. Urinary incontinence, treatment of urinary incontinence. Stress incontinence and its subtypes

Why do I urinate frequently after sex? Sexual life for every person is an important component of not only emotional well-being and satisfaction, but also physiological health. Any disorders in this area can lead to depression and isolation, so you should not ignore unusual manifestations. One of these unpleasant moments after sexual intercourse may be frequent urination.

These symptoms indicate the development of changes or pathologies and require timely diagnosis and treatment. Frequent urination after sex may be normal or a possible pathological reaction if there are additional signs.

In women who are active sex life, arise painful sensations that are associated with urinary functions. These signs indicate the development of postcoital cystitis - a disease of the bladder due to the action of dangerous microorganisms.

Due to the structural features of the female reproductive organs discomfort occur much more often, and the development of this disease is accompanied by the following reasons:

Traumatic sexual intercourse, due to which the integrity of the mucous membranes may be disrupted, is a favorable environment for the development of various kinds of diseases.
Lack of normal intimate hygiene leads to the development of fungi and bacteria, which are the main causative agents of gynecological pathologies. This point applies to women and men equally.
Weakened immunity leads to many disorders and disorders, and it also makes the body vulnerable to various viruses. Therefore, in women who suffer from chronic diseases and frequent stress, even minor irritants can cause cystitis.
Problems with metabolism, which can be caused by disruptions in the endocrine system and excess weight. Such disorders reduce local immunity and allow the development of many pathologies.
Hormonal imbalances, on which the general condition of the body depends, also affect the normal functioning of many systems.
Changes in the usual structure of microflora in the vagina. Based on this disease, infectious diseases and any other changes may occur.

Frequent urination after sexual intercourse in men and women, pain in the lower abdomen have certain causes that can be identified with the help of a specialist.

Symptoms

Ordinary cystitis differs from postcoital cystitis, not only in pathogens, but also in manifestations and signs. Postcoital cystitis occurs a short time after sex, unpleasant sensations, discomfort, and pain when urinating begin.

Pain during urination after sexual intercourse has the following symptoms:

soreness, burning;
general malaise;
heat;
aching pain in the lower abdomen.

In addition, women may spontaneously release a small amount of urine, and various impurities and color changes may also appear.

These manifestations require an immediate response from a specialist, so any unpleasant manifestations require competent correction from a specialist. Only with the help of a set of diagnostic procedures can pathogens be identified and an accurate diagnosis made.

Men can also have similar manifestations, but much less frequently than women. This disease depends on the structural features of the body, so it is practically reduced to zero in the stronger half. Cystitis in men has the same symptoms, but it manifests itself due to other reasons.

When frequent urination occurs after sex, in most cases the disease is accompanied by other manifestations.

The specialist who treats this pathology is a urologist or gynecologist.

The doctor will make the necessary preliminary conclusion during the examination, and will also refer you for the following studies:

General analysis blood, which will allow us to determine the extent inflammatory process in organism.
A general urine test, which will reveal any inaccuracies in the functioning of the excretory system.
Bacterial culture, using this analysis, can determine the flora, bacteria that are in the urinary system.
Ultrasound genitourinary system, this study is the most high-quality marker for determining the condition of the genitourinary system.
A visit to a gynecologist who can determine the presence of other diseases that can cause similar symptoms.

An integrated approach to determining an accurate diagnosis will allow you to determine the root cause of the disease as accurately as possible. It is also important for further treatment to determine the pathogen that can cause this reaction in the body. In order to accurately make a diagnosis, as well as for maximum accuracy of the study, it is necessary for both partners to visit a doctor.

Pain when urinating after sex can bother both men and women, so for a reliable diagnosis it is important to see a doctor together.

Treatment and prevention

After sexual intercourse, urination may be a painful manifestation; in order to get rid of such symptoms, it is necessary to treat the cause of this disease. For complex therapy, special drug treatment is prescribed, the effect of which is aimed at eliminating the symptoms and signs of cystitis.

Taking into account all the nuances, antibacterial drugs and antibiotics can be prescribed, it all depends on the complexity of the disease, its characteristics, as well as the course of the inflammatory process.

During the treatment period, it is important to follow all the doctor’s recommendations in order to avoid the development of a chronic form of the disease. You should not self-medicate or choose any medications yourself; this approach can aggravate the disease and lead to long-term treatment. During the therapy period, the doctor may prescribe certain painkillers, which should be taken according to the instructions, taking into account all the characteristics of the body.

To ensure that unpleasant manifestations do not bother you, you should use preventive measures that will maximally protect the body from possible diseases:

careful observance of personal and intimate hygiene;
sex should be protected especially with a new partner;
watch your immune system, take the necessary vitamins;
visit a specialist in a timely manner.

If after sex you experience pain in the lower abdomen and frequent urination, this indicates various diseases. To eliminate complications in the urethra, you should undergo a complete diagnosis, as well as visit a doctor for thorough treatment of the disease. Burning sensation when urinating is a deviation from the norm, therefore it is an alarming signal and an important reason to seek help.

About 80% of women complain of urinary incontinence during sex. A similar problem plagues every fourth woman over 18 years of age. In addition to inconvenience, shame and the appearance of complexes in the future, uncontrolled urine output during sexual intercourse may indicate more serious problems, often associated with diseases of the genitourinary system.

Urinary incontinence during sex is a very unpleasant phenomenon that can develop due to different reasons in both sexes.

Causes of urination during sexual intercourse in women

Sexual stimulation during intercourse that puts pressure on bladder or urethra in combination with weakened pelvic floor muscles.
Overactive bladder is the appearance of a sudden and urgent urge to urinate due to its involuntary contraction.
Infections in the bladder or prostate gland.
Certain medications, including antidepressants and blood pressure medications.
Natural diuretics and bladder irritants such as caffeine and alcohol.
Chronic diseases, such as inflammation of the bladder, urethra, etc.
Stones in the kidneys or bladder.
Overflowing bladder.
Physical and nervous stress.

Urinary incontinence during sex can be caused by anatomical pathologies, diseases, mental disorders.

In some cases, urinary incontinence during sexual intercourse does not necessarily indicate the presence of any illness. Many women experience paraorgasm - a variant of orgasm during which the state before ejaculation is accompanied by a strong urge to urinate and the result is the involuntary release of a small portion of urine. As practice shows, after some time such phenomena cease without any treatment.

How to treat?

Urinary incontinence during sexual intercourse in women should not be ignored. Delaying treatment for this problem often leads to its exacerbation, and as a result, the symptoms become unbearable, treatment becomes more problematic and lengthy, and the disease itself becomes chronic. There are also cases when a large amount of fluid released from the glands during orgasm is mistaken for urination.

With constant pain, especially if it is accompanied by pain in the lower abdomen, it is important to urgently consult a gynecologist or urologist.
Exercises for sexual urinary incontinence
If the cause of urinary incontinence lies in physical overexertion, weakening of the muscles of the coccygeal-pubic region or stress, then you should pay attention to exercises to strengthen the intimate muscles. According to most doctors, the most effective exercise is Kegel exercises - easy-to-use exercises that can be done anywhere, anytime. Procedure for carrying out the exercise:
First, find the right muscles. To identify the target muscles, stop urinating halfway through. Once your pelvic muscles are identified, squeeze them for 3 seconds without straining your abdominal muscles.
Add 1-2 seconds each week until you can squeeze your muscles for 10 seconds each time.
Repeat this exercise 10 to 15 times in a row, 3 times a day.

Lifestyle change
For some people, lifestyle changes may help prevent urination during sex:
Try different positions during sex. This will help you find exactly the one at which the pressure on the bladder is reduced to a minimum.
If you are overweight, losing weight can help. Consult your doctor for selection proper diet and creating a fitness training plan.
Limit drinks and foods containing caffeine or alcohol as they act as diuretics and are bladder irritants.
Try not to drink too much right before sexual activity, or at least go to the toilet first.

When urination occurs during sex, a person experiences a lot of psychological discomfort. Unfortunately, such a nuisance can happen to both a man and a woman, but the fairer sex is more susceptible to such danger. This is due to the peculiarities of the anatomical structure of the organs of the genitourinary system.

Many may have noticed that there is frequent urination after sex. The fact is that during intimate intimacy the bubble is high blood pressure, so the urge to defecate may even become uncontrollable. It is not uncommon for urination to occur during orgasm. Because muscles weaken after tension. Let's take a closer look at what all this may be connected with.

Causes

In representatives of the fairer sex, the bladder is anatomically located in close proximity to the vagina and clitoris. That is why during sex it is compressed. Frequent urination after sex in women is quite common, since during the entire period of intimacy this organ has undergone increased stress.

Types of urinary incontinence. Source: uromir.ru

There are several provoking factors that cause involuntary urination during sex:

Achieving orgasm;
High level of adrenaline release;
Presence of a history of chronic cystitis;
Entering into intimacy with a full bladder;
Having sex in a non-standard position.

The main reason that urination occurs during sex is considered to be the presence of a condition in a person such as the inability to retain biological fluid, that is, when the urge occurs, it pours out spontaneously. There are several types of incontinence, namely: stress, urgency and mixed.

The very first type is considered the most common. More than 50% of people encounter it, that is, at the time of the act of intimacy, men and women noted a single or regular spontaneous urination, which is caused by a long stay in a stressful situation.

Since the bladder experiences increased pressure during sex, it is subjected to increased physical stress. However, the provoking factor in this case is not only intimacy, but also laughter, coughing, lifting heavy objects, sneezing (any action that tenses the muscles of the lower abdomen).

The urgent type of urinary incontinence is characterized by a completely sudden bowel movement, when before this the person did not even feel the urge. In this case, people are diagnosed with overactive bladder. If this organ is working normally, then the brain will receive a signal that it is necessary to visit the toilet when it is 50% full.

Features of an overactive bladder. Source: propochki.info

Then there is a certain time for the fulfillment of natural needs. In the case of OAB, this signal arrives too early, so the woman or man immediately feels an urgent need to defecate. There is not always enough time to go to the toilet, and if we are talking about sexual intercourse, urination will happen immediately.

With a mixed form, it is quite difficult to establish the exact cause of urine leakage. The fact is that this condition can be caused either by a certain stressful situation or emotional shock, or by physical activity. This type of incontinence is diagnosed more often than the urgent type.

In men

Frequent urination after sex in men also has a physiological explanation. During intimacy, the opening of the bladder is blocked in the area where the urethra exits into the penis. This is necessary to prevent seminal fluid from penetrating into the urine.

Accordingly, we can conclude that men urinate during sex extremely rarely. But if a representative of the stronger sex has previously undergone treatment to eliminate a tumor on an organ, then this condition may be a side effect of the surgery.

Most often, when an oncological process is detected, male patients are prescribed a radical prostatectomy. The intervention is characterized by complete removal of the gland of the same name. However, almost every second patient after this experiences urine leakage or the inability to control urination during sex, coughing, and other stress.

Treatment

If a man or woman notices that she is leaking urine, or involuntary urination occurs during sex, then first of all you should contact an experienced urologist, who, after examination, will be able to determine the real reason of this violation.

A set of Kegel exercises for women.

The situation when urination occurs during sex is quite rare. It brings women not only inconvenience and shame in front of their partner, but can also indicate the presence of chronic diseases or pathologies. In most cases, this is due to the presence of diseases of the genitourinary system. Before looking for methods to solve this problem, let's look at its possible causes.

Causes of urination during sexual intercourse in women

After orgasm, the muscles of the coccygeal-pubic region relax, in this case urination can occur without a preliminary urge.
Due to the active work of the heart and kidneys during sexual intercourse, during which a significant amount of adrenaline is produced.
In women, urination during intercourse can be confused with the release of lubrication or Skin's fluid during ejaculatory orgasm.
The pathological cause of urination may be the presence of chronic diseases such as cystitis, urethritis and others. During sex, the friction of the male penis affects the wall of the bladder due to the anatomical features of the structure female organs, which causes the urge to go to the toilet. After such sexual intercourse, women experience painful urination.
A full bladder can cause this problem. Before sexual intercourse, it is advisable to go to the toilet and defecate.
Urination disorder associated with disturbances in the transmission of nerve impulses.
Stress, specific postures, physical strain, tumors.

Diagnosis and treatment of pathology

To solve such a delicate problem, you need to seek help from a urologist.

If involuntary leakage of urine during sexual intercourse is a common occurrence, then to solve the problem you must first contact a urologist to find out the exact cause and prescribe treatment. For diagnosis, tests and ultrasound are prescribed. Each individual case is considered and treated individually. In severe cases, it is prescribed surgical intervention. Drug treatment prescribed in the presence of chronic diseases or infections of the genitourinary system.

An alternative method of solving the problem is strengthening the intimate muscles. Kegel exercises are considered effective in this regard. IN modern world There are also separate trainings - vumbilding, which is training of intimate female muscles. Classes are conducted under the guidance of a specialized trainer, which makes training more effective than at home.

More than half of women experience the problem of urinary incontinence at least once. Sometimes it occurs in young girls after childbirth, sometimes it causes inconvenience to older people, and for some it accompanies for a long time.

Fear of losing urine can lead to psychological and sexual disorders, cause depression and hinder personal and career growth. Incontinence (another name for incontinence) always reduces the quality of life and therefore requires special attention.

There is even a special international organization on urinary continence, which conducts research and develops all kinds of treatments. Experts call urinary incontinence any involuntary release of urine. But depending on the conditions, time of day, and circumstances of incontinence, several types of incontinence are distinguished.

Types of urinary incontinence

stressful
imperative (urgent)
mixed
other types (continuous leakage of urine, bedwetting, unconscious incontinence)
Iatrogenic incontinence (due to medication)

The first three types are the most common and are characteristic of women.

Stress urinary incontinence

This type of incontinence accounts for half of all cases of uncontrolled urination. The main cause of this condition is the improper functioning of a special muscle - the urethral sphincter. The weakening of this muscle, together with a periodic increase in intra-abdominal pressure, leads to leakage of urine or even complete emptying of the bladder.

Symptoms of stress urinary incontinence

leakage of urine in varying amounts during physical activity, laughter, coughing, sexual intercourse, straining
no irresistible urge to urinate
sometimes – combination with incontinence of gases and feces

There are many reasons why stress urinary incontinence can occur.

Pregnancy

Almost all women in an interesting position experience discomfort due to the leakage of a small amount of urine. They are forced to plan their walks based on the location of the toilets. Moreover, in the first weeks of pregnancy and shortly before childbirth, the symptoms of incontinence become more pronounced. This is due to the changed hormonal levels and pressure of the uterus on the pelvic organs.

Especially often, incontinence occurs after spontaneous childbirth with a large fetus with a perineal incision and other manipulations. As a result, the muscles and ligaments of the pelvic floor are damaged, intra-abdominal pressure is distributed unevenly and the sphincter ceases to perform its function. It is after ruptures or inaccurate incisions of the perineum (episiotomy) that gas and fecal incontinence joins urinary incontinence.

Surgeries on the pelvic organs

Any interventions related to the uterus bladder, rectum, cause adhesions and changes in pressure in the pelvis. In addition, operations are sometimes complicated by fistulas between organs, which also leads to urinary incontinence.

Age-related changes

With age, the elasticity of the ligaments and muscle tone decrease, which inevitably leads to sphincter dysfunction. After the onset of menopause, the body experiences a deficiency of estrogen, which is the cause of urinary incontinence in older women.

In addition to these main reasons, there are risk factors. They may be a background to the development of urinary incontinence, but their presence will not necessarily lead to this disease.

Risk factors

Caucasian
heredity (if there is a disease in close relatives or cases of enuresis in childhood, the risk of incontinence is greater)
obesity (especially in combination with diabetes)
neurological diseases (stroke, heart attack, parkinsonism, spinal injuries)
urinary tract infection
digestive disorders
taking certain medications
anemia

Stress urinary incontinence causes a lot of trouble for women. Refusal to play sports, fear of leaking urine in public, constant nervous tension have a negative impact on health. Therefore, it is important not to be embarrassed or hush up this topic, but to consult a doctor in a timely manner.

Urge incontinence

Normally, the urge to urinate appears after a certain amount of urine accumulates in the bladder. Feeling this urge, a woman can successfully restrain it to the nearest toilet. With increased reactivity of the bladder, even a small amount of urine is enough to cause a strong, unbearable urge. And if, by luck, there is no toilet nearby, then there is a risk of losing urine.

The cause of this disease is considered to be an overactive bladder. Due to the special mobility of the psyche and the speed of nerve impulses, the muscles of the sphincter and bladder react to the slightest irritation. Therefore, urine can be missed if there is a small accumulation of it in the bladder, especially if there is any external irritant (bright light, the sound of pouring water, etc.)

Main symptoms of urge incontinence

frequent urge to urinate
urges are almost always sudden
uncontrollable urge to urinate
the occurrence of urges is often provoked by external circumstances

The risk factors for urgency are the same as for stress incontinence because the two types are often combined.

Differential diagnosis of urinary incontinence

Iatrogenic incontinence

Some medicines in the list of their side effects have urinary problems:

adrenergic agonists (pseudoephedrine) can cause urinary retention followed by incontinence; they are used to treat bronchial diseases;
all diuretics;
colchicine (to treat gout);
some drugs with estrogens;
sedatives and

After stopping taking these medications, the unpleasant symptoms go away on their own.

Other types of incontinence

Rarer causes of urine loss are usually associated with organic pathology. This can be damage to the brain and spinal cord as a result of tumor processes, injuries, strokes, multiple sclerosis.

Only a doctor can determine the exact cause of the problem. Usually, with incontinence, women turn to gynecologists and urologists. IN Lately A narrow specialty appeared - urogynecology, which deals with issues of the female genitourinary system.

Urinary incontinence examination

Detailed story to the doctor about your complaints

Factors that provoke incontinence, the time of onset of symptoms, their severity, and additional complaints are important. In addition, you need to ask your mother, grandmother, and sisters about similar symptoms in order to identify a hereditary predisposition. Be sure to note if there were cases of chronic nocturnal enuresis in childhood.

You can fill out a questionnaire designed specifically for people with incontinence problems. Incontinence Symptom Questionnaire (ISQ):
1. How long have you been experiencing symptoms of incontinence?
2. Has the volume of urine lost changed since the onset of the disease?
3. How has the incidence of urinary incontinence changed since its inception?
4. Indicate how often the following actions result in incontinence (never, sometimes, often).

physical exercise, including running, sports
sneezing
cough
lifting weights
change in body position: transition from a sitting to an upright position
the sight or sound of rushing water
psycho-emotional stress
hypothermia

5. Do you have an irresistible urge to urinate?
6. How long can you hold urine when you feel the urge?
7. How often do you lose urine?
8. When does urinary incontinence occur most often?
9. Do you feel your underwear getting wet without the urge to urinate?
10. Do you wake up at night to urinate?
11. Please indicate how much urine you usually lose.
12. On a 5-point scale, rate the degree of influence of urinary incontinence on your daily life: _____ (0 - does not affect, 5 - significantly affects).

Keeping a urine diary

Detailed records of urination and urinary incontinence will help your doctor make the correct diagnosis and prescribe treatment.

Time	What liquid did you take and in what quantity? (water, coffee, juice, beer, etc.)	How many times did you urinate in one hour?	How much urine? (a little, medium, a lot) or indicate in ml	Experienced Do you have an unbearable urge to urinate?	Have you ever had an episode of involuntary leakage of urine?	How much urine was passed during this episode? (a little, medium, a lot) or indicate in ml	What were you doing during the involuntary leakage of urine?
7:00 -8:00	Tea, 200ml	1	A little	—	—	—	—
8:00 -9:00	—	1	A little	Yes	Yes	A little	I went for a morning jog
9:00 –10:00
10:00 -11:00

PAD test

Often the concepts of “a lot” and “a little” differ from woman to woman, so it is difficult to assess the extent of the disease. This is where the pad test, or PAD test, comes to the aid of doctors. This method is used to obtain objective data on the amount of urine lost.

For the study, the woman must wear urological pads, weighing them before and after use. The duration of the test can vary from 20 minutes to two days, more often – about 2 hours. When performing a short test, it is recommended to drink half a liter still water.

Vaginal examination

Examination of the genital organs using gynecological speculum is necessary to exclude other diseases. During the examination, the doctor may find:

atrophy of the vaginal mucosa. After menopause, genital dryness associated with estrogen deficiency may worsen urinary incontinence.
prolapse or prolapse of the pelvic organs (see)
large fistulas

During examination, a cough test is performed: when coughing, you may notice the release of urine from the urethra.

Analysis of urine

Very often, with inflammatory changes in the organs of the genitourinary system, incontinence of small portions of urine occurs. Therefore, the detection of leukocytes, red blood cells or bacteria in the urine gives rise to examination for infections. To get an accurate result, you need to know the basic rules for collecting urine:

use the first, “morning” urine
collect a medium urine sample
thoroughly toilet the vagina before urinating
cover the vagina with a clean cloth during collection

Imaging (ultrasound, MRI)
Urodynamic studies (allow you to determine the type of incontinence)

Treatment of urinary incontinence

Depending on the cause of urinary incontinence in women, treatment is carried out by gynecologists, urologists in a clinic, or surgeons in a hospital.

general treatments
treatment of stress incontinence
treatment of urge incontinence

Therapy for any type of urinary incontinence should begin with the simplest and most available methods. These methods include lifestyle modification and special exercises. This is a lifestyle change:

Weight control for obesity	a necessary step in the treatment of all types of urinary incontinence. Overweight constantly increase intra-abdominal pressure, disrupt the normal arrangement of organs, causing urination problems. Depending on the degree of obesity, psychological, medicinal or surgical treatment is used.
Reducing consumption of coffee, tea and other caffeinated drinks	Caffeine-containing drinks provoke increased urination, so the risk of losing urine increases significantly. But excessive restriction of fluid intake is also undesirable: this will not reduce incontinence, but will have a negative effect on overall well-being.
To give up smoking	A huge number of studies have been conducted to identify a direct connection between smoking and incontinence, but the topic still remains unexplored. We can only say with certainty that chronic nicotine bronchitis with stress urinary incontinence is a huge problem, since with every coughing movement a woman loses urine. This point also includes the treatment of chronic respiratory diseases.
Establishing a urination routine	This method gives very good results for urge incontinence. Its essence is to visit the toilet at strictly defined hours, regardless of the strength of the urge. At first, the intervals between urinations do not exceed 30-60 minutes, but over time you can develop a more convenient regime.
Pelvic floor muscle training	The main goal of such training is to tone the muscles, restore sphincter function and regulate the phases of filling and urination. With the help of special exercises and devices, a woman can completely take control of the sphincter muscles, eliminating the sudden loss of urine.
Treatment of chronic respiratory diseases Psychological setting to distract from the desire to urinate

Kegel exercises

The essence of such gymnastics is as simple as possible. First you need to “find” the necessary pelvic floor muscles: perivaginal and periurethral. To do this, you need to sit while imagining the urge to urinate and try to hold back this imaginary stream of urine. The muscles involved in this process need to be trained regularly.

Contract and relax them three times a day, gradually increasing the time of contraction from a few seconds to 2-3 minutes. This process will be invisible to others, so you can practice not only at home, but also at work, while driving in a traffic jam and in any free time.

After establishing control over the muscles at rest, you can complicate the task: try to contract them when coughing, sneezing and other provoking factors. You can diversify the manipulations with the muscles to achieve a better effect.

slow compressions
fast contractions
pushing out (similar to the pushing period of childbirth)
retention of stream during actual urination

Biofeedback training

The main disadvantage simple exercises Kegel is the inability to control their implementation. Sometimes women, along with the necessary muscles, also tense others, increasing intra-abdominal pressure. Not only does this ruin your entire workout, but it can also make the problem worse.

A set of exercises with biofeedback (BFB) includes a special apparatus for recording muscle tone. With its help, you can monitor the correct execution of contractions, and, if necessary, perform electrical stimulation. Biofeedback training has been proven to improve muscle tone and urinary control.

Contraindications to biofeedback training:

inflammatory diseases in the acute phase
severe diseases of the heart, kidneys, liver

Use of special simulators

For training, many compact devices have been created that allow you to strengthen the pelvic floor muscles with maximum efficiency and perform all the necessary exercises for urinary incontinence in women.

One of these simulators is the PelvicToner. This device, based on the properties of a spring, allows you to gradually and correctly increase the load on the intimate muscles, strengthening them. It is easy to use and care, and its effect is confirmed by clinical trials.

Psychological training

If you have a strong urge to urinate, you can try to distract yourself from the thought of it. Everyone has their own ways: think about plans for the day, read an interesting book, take a nap. The main task is to make the brain forget about going to the toilet, at least for a short period.

Treatment of stress incontinence

In addition to the general incontinence treatments described above, treatment for stress incontinence requires the intervention of a physician. Conservative treatment with the help of medications is not very popular, since it helps only in a small number of cases.

Drug treatment:

At mild degree stress incontinence, when the anatomical structures have retained their integrity, are sometimes used:

Adrenergic agonists (Gutron) increase the tone of the sphincter and urethra, but also affect vascular tone. Used extremely rarely due to low effectiveness and side effects (increased blood pressure)
Anticholinesterase drugs (Ubretide) also increase muscle tone. Recommended for women whose examination results have revealed bladder hypotension.
The antidepressant Duloxetine (Cymbalta), effective in half the cases, but has side effects on the digestive system.

Treatment of stress incontinence with tablets is very rare due to frequent relapses and side effects.

Surgical treatment

For stress urinary incontinence in women, surgery is the treatment of choice. There are several surgical procedures that vary in complexity. Preference for one operation or another is given depending on the degree of incontinence and the anatomical features of the woman’s urethra.

Contraindications to all types of surgical treatment are:

malignant neoplasms
inflammatory diseases of the pelvic organs in the acute phase
diabetes mellitus in the decompensation phase
blood coagulation diseases

Sling operations (TVT and TVT-O)

These interventions are minimally invasive, last about 30 minutes, and are performed under local anesthesia. The essence of the intervention is extremely simple: insertion of a special synthetic mesh in the form of a loop under the neck of the bladder or urethra.

This loop holds the urethra in a physiological position, preventing urine from leaking out when intra-abdominal pressure increases.

To insert this mesh, one or several small incisions are made in the vagina or inguinal folds; they do not create a cosmetic defect. Over time, the mesh seems to grow into the connective tissue, firmly fixing the urethra.

Recovery after such operations occurs very quickly, the effect is felt almost immediately. Despite the attractiveness of sling operations, the likelihood of relapse still remains. In addition, if there is detrusor instability and anatomical defects of the urethra, this surgical intervention may be unsuccessful.

Despite the difficulties described above, minimally invasive loop surgery is the gold standard in the treatment of stress incontinence.

Injections of volume-forming drugs

During the procedure, under the control of a cystoscope, a special substance is injected into the submucous membrane of the urethra. More often it is a synthetic material that does not cause allergies.

As a result, the missing soft tissues are replaced and the urethra is fixed in the desired position. The procedure is low-traumatic, performed on an outpatient basis under local anesthesia, but also does not exclude relapses.

Laparoscopic colposuspension according to Burch

The operation is performed under general anesthesia, often laparoscopically. The tissues located around the urethra seem to be suspended from the inguinal ligaments. These ligaments are very strong, so the long-term results of the operation are very convincing.

But due to the type of anesthesia and the complexity of the procedure, colposuspension has more contraindications and complications than sling operations. Typically, such an intervention is performed after an unsuccessful loop procedure or in case of violations of the anatomical structure of the genitourinary apparatus.

Colporrhaphy

Suturing of the vagina with special absorbable threads, used for prolapse of the pelvic organs. The operation has a number of complications (tissue scarring, for example) and loses its effect after a few years.

Treatment of urge incontinence

Unlike stress incontinence, surgical treatment is ineffective for urgency incontinence. All women with this problem are first recommended to try general treatment methods (non-drug). Only if they are ineffective can you think about drug therapy.

Drug treatment

In the treatment of urge urinary incontinence in women, tablets are very effective. There are several classes of medications, the main task of which is to restore normal nervous regulation of urination.

Drugs that reduce the tone of the bladder wall reduce the strength and frequency of its contractions. The most common medications: Driptan, Detrusitol, Spazmex, Vesicare.
Drugs that relax the bladder during the filling phase and improve its blood circulation: Dalfaz, Kaldura, Omnic.
For incontinence in menopausal women, when there is estrogen deficiency, hormone replacement therapy or special ointments are used. An example of such an ointment is Ovestin, a cream containing an estrogen component. Its use can reduce dryness and itching of mucous membranes, reducing the frequency of urinary incontinence.

Treatment of urinary incontinence in women is a complex task that requires an integrated approach and strict implementation of all specialist recommendations. A few simple rules will help you avoid or delay the manifestations of this disease as much as possible.

Prevention of urinary incontinence

Maintain the body's water balance. To do this, you need to drink 1.5-2 liters of still water per day. Drinking too much and not drinking enough can be harmful to your health.
Try to create your own urination routine. It is quite possible to train yourself to empty your bladder at a certain time. For example, in the morning before getting ready for work, during the lunch break, immediately upon arriving home, visit the toilet and consolidate this habit.
Fight excess weight (on your own or with the help of a specialist)
To refuse from bad habits
Reduce consumption of caffeine-containing foods and salty foods
Fight constipation, if any. To do this, you can eat foods rich in fiber (vegetables, fruits, especially prunes, figs), drink enough liquid, and drink half a glass of kefir at night. For chronic constipation, you can use herbal laxatives (after consulting a doctor (see)
Strengthen the pelvic floor muscles before planning pregnancy, which will help avoid perineal tears during childbirth
Enjoy life and maintain a positive attitude

Main conclusions:

Urinary incontinence is a very common problem among women.
Without treatment, urinary problems are unlikely to go away on their own.
To determine the type of incontinence, you need to undergo an examination, including filling out a questionnaire and keeping a urination diary.
Stress incontinence is treated with surgery, and urge incontinence is treated with medication.
You can independently prevent incontinence by leading a healthy lifestyle and strengthening your pelvic floor muscles.

Urinary incontinence is a serious problem that requires treatment. It’s better to spend a little time going to the doctor and getting it fixed than to be embarrassed and tormented all your life.