Urinary Incontinence
Urinary incontinence is very common, especially in the developed countries. In fact, it is estimated that approximately 50 million of the population residing in developed countries suffer from this predicament. Medical research conducted in UK indicates that about 13% of women and 5% of men suffer from this disorder. From the gathered results, it is evident that the disorder is more common in women than men since the results show a ratio of two is to one respectively.
In addition, this disorder is more prevalent in older adults. In fact, about 35% of the older population (aged 60 years and above) suffers from this disorder.
However, this figure is a speculation because a higher percentage of individuals suffering from the disorder do not seek medical attention. This is because they feel embarrassed to talk about the situation. On the other hand, there is a myriad of ways used to define the disorder. Therefore, knowing the exact number of individuals suffering from the condition is difficult. The most common types of the disorder include stress and urge incontinence.
Stress incontinence occurs when the pelvic floor muscles loss their elasticity and thus are too weak to holds urine when the bladder is under pressure. These are the muscles that keep the bladder closed.
This is what happens when individuals leak urine after laughing, coughing, sneezing, climbing stairs, exercising or lifting a heavy load. Also, the pelvic floor muscles can become weak when they are overstretched for instance by rapid weight gain, diabetes and childbirth.
The latter disorder occurs when urine leaks out uncontrollably while at the same time, individuals experience an intense urge of urinating. Individuals get this feeling often and on the downside may soak their clothes because they leak a large amount of urine.
This also happens when the bladder contains a very small amount of urine. In addition, this can happen when the pelvic floor muscles stimulate the urge of urinating because it is overactive. This condition is normally referred to as overactive incontinence.
The over activeness may be triggered by emotional stress, bladder irritation, multiple sclerosis, spinal cord injury, spina bifida, stroke and Parkinson’s disease just to mention but a few. There is also a possibility of one suffering from the two types of the disorder simultaneously. Such a condition is commonly referred to as mixed urinary incontinence. Other causes of the disorder may include nerve damage, use of certain medicines, constipation, urinary tract infection, and prostrate problems. Also, over dependence of caffeine and cola can contribute to development of urinary incontinence.
So how does one get rid of this embarrassing situation? The treatment of urinary incontinence depends on a plethora of factors including ones lifestyle, results from the clinical tests and the type of problem triggering the disorder. Usually, patients suffering from this disorder are placed under a basic evaluation for their medical history to detect a common patter of urine leakage and voiding. This helps in determining the type of urinary incontinence the patients are suffering.
Moreover, urologists can gather prudent facts like illnesses that individuals have suffered the type of drugs that they have used or are using, if they have ever had surgery or if they are facing any strenuous phase. These factors may be the underlying cause of the predicament. In addition, tests such as urinalysis, cystoscopy, physical examination, blood test, ultrasound, cotton-swab test, urodynamic studies, measurement of post void residual urine volume (PVR) and cough stress are also conducted.
The physical examination enables the urologists to detect any medical conditions like tumours, poor reflexes and stool impaction that may trigger the disorder. Furthermore, the patients are supposed to record the amount of urine they pass and their pattern of voiding in a day. The gathered data plays a crucial role in determining the type of urinary incontinence a patient is suffering.
Those suffering from intense symptoms are placed under a videourodynmic study.
According to the diagnostic results, urinary incontinence patients may be subjected to behavioural management, surgery, conservative or medical treatment. Behavioural management may entail training the bladder to hold urine for a long period of time. This is mainly done by delaying to urinate after getting the urge to do so. Individuals can begin by trying to hold the urine in their body for about 10 minutes and gradually increase the duration. This should be done until individuals are able to separate their trips to the toilet with two to four hours.
Breathing deeply and slowly as well as distracting one can help individuals delay urination. Alternatively, individuals can train their bladder via double voiding. They should try to urinate again immediately after they urinate. In the process, they will train their bladder to fully empty the urine. Behavioural management may also include fluid and diet management as well as scheduled toilet trips.
On the other hand physical/ conservative therapy entails doing pelvic floor muscle exercises (kegel exercises) to strengthen the urinary sphincter and the pelvic floor muscles. Also, the pelvic floor muscles can be strengthened via electrical stimulation.
Usually, electrodes are placed into the vagina or rectum on a temporal basis to stimulate the muscles and in the process strengthen them.
On the other side, medicines such as anticholinergics, topical estrogens, duloxetine and imipramine are used to treat urinary incontinence. At other times, medical devices such as urethral insert and pessary are placed into the vagina or rectum to treat the disorder.
Surgery is usually the last option. It is mainly used to treat intense conditions. The surgical procedures used include bladder neck suspension, sling procedures and artificial urinary sphincter. The procedures are aimed at strengthening the pelvic and urethra muscles so as to enable individuals control urination.
Overcoming Urinary Incontinence
Anyone suffering from or dealing with Urinary incontinence already knows how difficult the experience can be, whether it’s actual bladder leaks or just the need to go to the bathroom more often. It affects all areas of your life, from your general health, social life, sleep, even your independence.
If you’re looking for a one thing cures all solution to urinary incontinence, you won’t find it. But, there are a lot of things you can do to get relief from this condition. In some cases you can eliminate the condition entirely.
Urinary incontinence is caused by a couple of things:
A. Physical problems.
B. Nutritional problems.
While the conditions can be caused by complications of surgery and some mental conditions I won’t cover them here, but, many of same methods would help in these cases as well.
1. Exercise!
Start strengthening the abdominal muscles, both men and women alike. Flex the muscles as if you were trying to hold the urine in your bladder. This can be done almost any time, while driving working or just sitting watching TV. It only takes minutes and your effort will be well rewarded.
2. Diet!
Watch what you eat and drink. Certain foods and in particular drinks can be more diuretic than others. Coffee, tea, colas, and anything else with caffeine, and the big one Alcohol…can all make you go to the bathroom more often. Cutting out these culprits will make a big difference in how often you need to go.
3. Modify your behaviour.
Don’t drink late at night before bedtime. Remember to eliminate caffeine and alcohol. When you do urinate, try staying a few moments longer. Sometimes you stop urinating to soon while your bladder is not yet empty, waiting for the urge to return will help to get your bladder completely empty.
Trying all or most of these things will help to control or even eliminate you urinary incontinence.
Urinary Tract Infection In Children
UTI in children are caused by bacteria. The infection of both urethra and urinary bladder is called cystitis. The UTI in children has to treat at the right time or otherwise it may lead to serious kidney problems. A girl is in high risk of affecting UTI because of the shorter urethra. Similarly, an uncircumcised boy is also in a huge risk of getting affected by urinary tract infection.
What Are The Symptoms Of Children’s UTI?
- High fever
- Poor feeding
- Vomiting
- Restlessness
- Excruciating pain during urination
- Repeated urination
- Waking often in the night to go to the bathroom
- The child losing control of urine and causing wetting problems
- Blood-stained foul-smelling urine
- Abdominal pain
- Constantly feeling the need to urinate
Of all the above mentioned symptoms persists in the child for a particular period of time. Then it is important that the child should be given the medical aid at the most.
Diagnosis of UTI urinalysis urine culture ultrasound of the urinary bladder during urination is taken
Prevention of children’s bladder infection
- Good toilet habits
- Diet must include sufficient amount of water
- Avoiding caffeine is the one of the best preventing measure
- The food items that can control infection include almonds, cashews, pine nuts, breads, pasta, potatoes, rice, melons, pears, home-grown tomatoes, acid-free drinks, garlic etc.
- Frequent diaper changing in infants is necessary to avoid UTI.
- Personal hygiene
- Proper wiping after defecation
- Empty the bladder by double voiding
- Constipation should be treated and take necessary steps to avoid it
- Bubble baths should be avoided
- Wear cotton undergarments
- The parents should take initiative to cultivate the above mentioned habits and routine in their children.
Bladder Mesh – Transvaginal Mesh And Incontinence
Surgical mesh is a type of polymeric screen that is implanted through surgery, to support tissue or bones that have become weak. Since the 1950s, this type of mesh was used for hernia treatment. Approximately 20 years later, gynaecologists started using surgical mesh to treat vaginal tissues that needed reinforcing and pelvic organ prolapsed (POP).
It was only in the 1990s that doctors started choosing vaginal surgical mesh or transvaginal mesh to treat the problem of stress urinary incontinence (SUI). While the product has been effective there have arisen a number of surgical mesh problems arising from the use of defective vaginal mesh resulting in vaginal mesh erosion and other bladder mesh surgical complications.
To start out with, surgical mesh products were not officially approved and available. Surgeons typically cut the mesh (metallic or polymeric) themselves to perform procedures. As manufacturers began identifying the need for surgical mesh, it was developed to meet medical standards and growing demand. There are different kinds of surgical mesh in use today: • Surgical mesh made from animal tissues
• Synthetic surgical mesh of the absorbable kind
• Polyester or polypropylene surgical mesh that is non-absorbable – this is the most common type of vaginal mesh in use for female stress incontinence and other surgeries.
Recently, a lot of attention has been focused on the post-surgical complications that are arising from the use of surgical mesh. The problems appear to be centred round surgical mesh used for pelvic problem surgeries when it was designed for abdominal use. Testing of the suitability and safety of surgical mesh prior to receiving FDA approval is essential in the medical field.
The FDA has put out a statement to admit its error in stating publicly that mesh surgery complications are rare. There are thousands of cases of surgical mesh problems that have come to light. These cases revolve round SUI and POP surgeries performed using surgical mesh. It is estimated that approximately half a million or more women undergo surgery where bladder mesh is used in the process.
By FDA estimation, the spike in surgical vaginal mesh erosion problems occurs in approximately 10 percent of the women that undergo surgery within a year of said surgery. The original surgery is then followed by several other surgeries to remove the mesh.
Problems that arise include vaginal mesh erosion referred to as protrusion or extrusion; infection, pain, organ perforation, bleeding, vaginal scarring, urinary problems, recurrent prolapsed, neuro-muscular problems, emotional problems and dyspareunia (sexual intercourse problems). Almost all of the problems require further medical intervention and treatment; sometimes hospitalization and surgical treatment, which sadly does not always resolve the problem.
Approximately 80 percent or more of the stress incontinence surgeries are treated by inserting the transvaginal mesh through vaginal incision. The mesh in the form of a bladder sling, serves the purpose of elevating and supporting the bladder in bladder suspension surgery. Commonly experienced problems include pain, bladder obstruction and mesh exposure. The FDA is reviewing the use of vaginal mesh patch in surgeries and the surgical mesh problems that have arisen.
The organization is also reviewing data on the use of mesh specifically in stress incontinence surgeries. One example of surgical mesh problems is Mersiline, an old brand of synthetic mesh. The mesh was formed into a sling and used in stress incontinence surgeries. Studies show that the vaginal mesh erosion occurs approximately in 8% of all cases, which requires further surgery to remove the defective mesh.
One of the common treatments for SUI surgical mesh erosion problems is to remove the surgical vaginal mesh by performing another surgery and then sewing up the damaged vaginal tissues. A number of vaginal mesh lawsuits such as the infamous kegel mesh lawsuit are now working their way through the courts in class action suits.
Bladder Sling For Stress Incontinence
Bladder slings are implanted in the female human anatomy during a special surgical procedure to relieve incontinence. There are two primary approaches to this procedure. One approach is referred to as the transobturator tape (TOT) sling. The other is known as the tension-free vaginal tape (TVT) sling.
Why These Procedures Are Performed
Through the years, experts have suggested a variety of solutions of incontinence, all of which involved treatment or devices which proved unsatisfactory to most patients. These two surgeries are meant to return patients to normal or near-normal functioning. Instead of simply finding ways to better tolerate urinary incontinence, bladder slings actually cure the problem 90% of the time.
Surgeries which implant bladder slings address the problem very directly. Urinary incontinence occurs when the muscles under the urethra become weakened and give way during periods of excessive strain. The strain may be something as mundane as a simple cough. These procedures seek to provide support to the organs involved so that they no longer give way, except when the patient wishes them to do so.
How It Is Done
Surgical procedures which implant bladder slings either use pieces of the patients own body tissue or synthetic materials to provide support under the balder and urethra. Before the procedure begins, the surgical team will administer a local anaesthesia below the urethra. Surgeons continue with an incision in the patient’s thigh. The material for the sling, which is either fashioned from the patient’s own body or from a synthetic material, is later inserted and placed underneath the urethra. The abdominal wall naturally holds it in place.
Using a patients’ own bodily tissue to create bladder slings is complicated and not always ideal. It does decrease the chance of a patient’s body rejecting the implant. However, natural tissue has a greater chance of wearing away. Fashioning the sling also causes the surgery to take longer and increases the chance of infection.
The tension free synthetic bladder slings that many doctors use have a high success rate. They are infused in the flesh of the abdominal wall and held in place by scar tissue rather than stitches. This is a very dependable form of stabilization.
It may sound complicated, but this surgery actually only takes about 30 minutes. Surgeons need only make an incision about one centimetre in length, so recovery time is accelerated and a patient can expect very little post-surgery blood loss. On average, doctors have a 90% success rate with bladder slings.