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Women's urinary incontinence is mainly divided into stress, urgency, overflow and functional incontinence, the former two are more common. Stress incontinence is due to the relaxation of pelvic muscles, which leads to a decrease in the ability to control the urethra. Once the intra-abdominal pressure increases, such as laughing or lifting heavy objects, it will increase the internal pressure of the bladder and cause urine to flow out of the urethra. This disease is common in women who have given birth multiple times, and may also appear in chronic cough, constipation, obese people or the elderly. Patients with urgency incontinence often suffer from overactive bladder, and they must urinate as soon as they feel the urge to urinate.<\/p>\n
Women should always pay attention to whether there is any abnormality in the body. If there is a small amount of urine leakage and the situation persists, they should seek medical treatment as soon as possible. The doctor will make a clinical diagnosis for the patient, conduct a urodynamic test to record the bladder storage, urination and leakage of urine, and use the instrument to record the contraction and pressure changes.<\/p>\n
When women experience pelvic relaxation due to factors such as pregnancy, childbirth or long-term coughing, the pelvic floor muscles cannot lock the urethra. Just imagine that the urethra is like a water pipe. When it is placed on a solid flat ground (normal pelvis), the water pipe will be blocked and no longer leak (urine leakage). If the water pipe is placed on the wet mud floor (loose pelvis), it will be extremely difficult to stop the water even if you step on it tightly, resulting in incontinence.<\/p>\n
As the first step in treatment, patients can try non-surgical pelvic muscle exercise therapy, exercises to relax and contract the pelvic floor muscles. However, people with severe urinary incontinence or a prolapsed bladder should consider TVT or TVT-O surgery. The treatment mechanism of the two is the same. The operation mainly places an artificial sling in the suburethral tissue in the middle to support the pubourethral ligament. If the patient does not exert force, the sling will only support the middle urethra slightly, and will not affect urination. Only when the patient is exerting force or coughing, will it play a role in supporting the middle urethra. The operation time is not long and postoperative pain is less, so it is suitable for most people.<\/p>\n
Obstetrics and Gynecology Specialist Dr. Chan Wing Yin<\/p>\n