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Incontinence

0Incontinence (inability to prevent urine) is an involuntary flow of urine out the bladder. There are different types, causes and treatment options of incontinence in both sexes and at different ages.

Incontinence is more common in women than in men. In women, incontinence is divided into several groups:

  1. Stress type –happens during coughing, sneezing, lifting a heavy weight and sharp movements;
  2. Urgency type - after urgent need to urinate before getting to the bathroom;
  3. Mixed incontinence –mixed (unified) form of the two previous types;
  4. Overflow Incontinence –continuous incontinence in the form of dribble urination as a result of inability to empty the bladder. Mixed and urgency types are more common among patients. Urgency type comes to front with aging.

Causes:

1Risk factors potentially causing temporary incontinence:

  • Urinary tract infections
  • Constipation
  • Beverages that irritate the bladder (coffee, tea, preservatives etc.)
  • Excessive fluid intake
  • Dehydration
  • Drug intake (sedatives, diuretics etc.)

Risk factors potentially causing permanent incontinence:

  • Hamiləlik və doğuş
  • Artıq çəki
  • Uşaqlığın cərrahi olaraq götürülməsi
  • İrsi faktor
  • Nevroloji xəstəliklər (parkinsonizm, dağınıq skleroz və s. xəstəliklər)

Diagnosis

Initial:

  1. Ümumi qiymətləndirmə
  2. Həyat keyfiyyəti və müalicə istəyinin dəyərləndirilməsi
  3. Fiziki müayinə
  4. Qarının müayinəsi və nevroloji araşdırma
  5. Anamnez formaları: sidik qaçırma vəziyyəti, tipi, gündəlik həyata nə qədər təsir etdiyi ilə əlaqəli suallar soruşularaq şikayətlər obyektiv olaraq hesablanma aparılır.

Vaginal examination and stress test

2Anatomic assessment is made on the bladder and uterus when the bladder is full. Patient is exerted to check for incontinence.

Urine diary

Notes made on the times of urination, incontinence, conditions, quantity of incontinence and fluid on 1, 3 and 7th day. Cutter boxes are used for this purpose.

Lab analysis

Global urine, and if needed, blood analysis are made.

Other examinations

3After urination, residual urine is inspected by US; urodymanic, cystographic and cystoscopic examinations are conducted.

Treatment

Physiotherapy, etiologic and surgical treatment option is selected depending on the type, severity and root cause of the incontinence.

Physiotherapy treatment

  1. "Training" the bladder –it is recommended to train for realization of voluntary urination (deep breathing, making any movement to forget this feeling), double urination, stopping and resuming urination
  2. Programmed urination –urinating without urgency on regular basis (with 2-4 hour intervals)
  3. Regulating fluid intake, observing diet and daily habits, avoiding alcohol, coffee, restricting fluid intake, losing weight (for overweight patients).
  4. "Training" the pelvic muscles – training the pelvic muscles regulating urination. This is widely used particularly in stress incontinence.

Drug treatment - Efficiency of the muscarine sensitive receptor blockers reaches 60%

Surgical treatment - If other treatment options are unsuccessful, surgical treatment (hanging operations) option is more reasonable. This option (TVT, TOT) used last 10 years, has the efficiency of 80-90% during last 2-3 years.

Some phytotherapy methods

  • Coriander seeds are milled and mixed with honey, and taken one tablespoon every morning and evening.
  • Eat everyday fistful of pumpkin seeds
  • Drinking tea made from the branches of cherry-tree on an empty stomach several times a day
  • Add 200 ml of hot water onto the grinded one tablespoon of St.-John’s wort, brew by simmering 15 minutes on a slow heat. Drink 4 hours after cool-down.
  • In Russian folk medicine, a tea is made from equal portions of St.-John’s wort and centaury and drunk in a normal way.
  • Brew dried or fresh blackberry or bilberry fruits and take ½ glasses 4 times a day.
  • Add 200 ml of hot water onto one tablespoon of plantain leaf and brew for 1 hour. After straining, take 3-4 times a day 20 minutes before meal.
  • Washed and dried eggshell is milled and mixed with honey. Then make balls from the mixture and swallow couple of times a day.
  • Brew 40-50 of sage in 1 liter of hot water and take ½-1 glass of the fluid 3 times a day.
  • Add 200 ml of cold boiled water on 6 gr of milled wymote root. After 10 hours of brewing drink during whole day.