Urinary incontinence is a chronic disease that affects more than 15 million people in the United States and is a major problem in older adults. Although urinary incontinence is one of the most common urinary disorders, this problem is not adequately addressed due to the lack of health resources and health education. Studies indicate that more than half of women suffer at some stage of their incontinence, and most of them They wait at least five years to seek medical advice.
the definition :
The bladder is stored in the urine produced by the kidneys. When filling, the feeling of emptying of the bladder begins in the human. This occurs spontaneously. The sphincter muscles in the upper urethra relax and close to the bladder neck. At the same time, the muscles of the bladder contract and the sphincter of the urethra Sphincter Urethrae). After discharge, the bladder muscles relax and contract and contract the sphincter muscle of the urethra. In the case of incontinence, this occurs when the sphincter does not shrink completely or the bladder muscles contract at an inappropriate time. To understand the nature of the disease, we must know that there must be a physiological balance between two pressures in the human body, ie, abdominal pressure and muscle pressure The sphincter of the urethra to achieve control over the urine, when increasing the pressure in the abdominal cavity, that is when coughing or lifting something heavy from the ground or laughter increases the pressure of the muscle ulcer of the urethra higher than the high pressure abdominal cavity by coughing, laughing or lifting something heavy, The urine is not controlled The spleen and weakness of the sphincter are recurrent or stray birth. This muscle is weakened by pressure from the birth process and at the same time by weakness of the pelvic muscles in the pelvis. These muscles, which lift the bladder neck in normal cases, control urination, Pressure falls in the neck of the bladder lower than the level of the muscles of the abdominal basin and here occurs an anatomical abnormality and physiological characteristic of this area of the bladder.
Incontinence:
Primary Stress Incontinence: This is due to a physiological and anatomical dysfunction of the urethra due to the lower bladder neck level than the lower pelvic muscles. Secondary Intrinsic Muscle Dificiency: This occurs because of weakness in the muscle surrounding the urethra itself near the neck of the bladder because of damage to the nerves that feed the muscle, or because of imbalance in the coordination between the contraction of the muscles of the bladder and muscle glaucoma, which controls urinary urethra. Urge incontinence: This occurs due to excessive bladder activity and the reasons for this organic smoothness is unknown but a combination of factors can lead to infection, especially in the elderly, and overcome this infection in patients with neurological disorders and some neurological diseases such as sclerosis Multiple Sclerosis and Spinal Gord Injury due to Accidents and Injuries, Diabetes Mellitus and Parkinson Disease.
The feeling of emptying the bladder is a neurogenic origin, since the bladder emptying of the urine not only requires the interference of neurotransmitters between the bladder and spinal cord, but also requires neurotransmitters that connect the bladder to the central nervous system, which triggers the alerts of the feeling of exhaustion and discomfort to the brain, (Alfa) to transmit neurotransmitters from receptors that determine the bladder's fullness and availability, and Intravesical C-Fiber, which determines harmful and painful alerts in the bladder, and to explain the mechanism of action of the nerve fibers- C-Fibe This is why the fibers in the bladder have the same functions and effects on the central nervous system when any inflammation or swelling occurs. Therefore, the nerve fibers of the C- C-Fiber) is used in the treatment of disorders of the lower urinary system, including spontaneous incontinence, which disturb the patient's mood and leads to social isolation as well. Urinary incontinence in men: This occurs in most cases after prostate enlargement surgery or radical prostate cancer extraction in the case of malignant tumor of the gland.
Diagnosis:
In the past, the diagnosis of this disease was based on the patient's complaint with the clinical examination and the experience of the doctor, but today in the era of evidence-based medicine "Evidence Based Medicine" where the patient undergo certain tests to diagnose the type and whatever the experience of the doctor, Clinical examination of each patient and clinical examination. After the clinical examination, a Urodynamic examination is performed and an upward and downward examination of the urethra and bladder during urination is performed.
the cure :
The correct diagnosis of the condition is the success of the treatment and recovery of the disease, and successful treatment depends on the diagnosis of the stage of infection as there are three stages of primary and intermediate and advanced urinary incontinence and now have several Treatment methods for urinary incontinence vary according to clinical causes. Initially, before any therapeutic intervention for urinary incontinence, it must be ascertained that there is no bacterial infection in the bladder because it may lead to temporary urinary incontinence.
There are several methods of treatment for urinary incontinence and depends on the stage of the disease and the condition of the patient's health and age as well as other factors. Smooth treatment is divided into three: rehabilitative. Pharmaceutical. Surgery.
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