What are the treatments for stress urinary incontinence?

Everyone has experienced some symptoms of inability to urinate in normal times, but some people may experience urinary incontinence in normal times. This is not a type of stress urinary incontinence. The normal treatment method is mainly medication or non-surgical treatment. Surgical treatment can be chosen when necessary.

1. Non-surgical treatment

(1) The method of strengthening the pelvic floor muscles is to ask the patient to consciously perform contraction and relaxation exercises of the anal and perineal muscles on a regular basis every day to enhance the tension of the pelvic floor muscles and urethral muscles and improve the muscle's reactive contraction force to pressure. For mild cases, it can improve symptoms; for severe cases, it can improve the efficacy of surgery. So it is both a treatment method and a preoperative preparation.

(2) Functional electrical stimulation therapy Functional electrical stimulation therapy has two types of electrodes: anal suppositories and vaginal suppositories. Electrical stimulation is used to enhance urethral closure. Its mechanism:

① Stimulate the efferent fibers of the pudendal nerve to enhance the function of the levator ani muscles and other pelvic floor muscles and striated muscles around the urethra, and increase the urethral closing pressure;

② Stimulate the afferent fibers of the pudendal nerve, connect to the detrusor nucleus of the sacral spinal cord through the neurons, inhibit the excitability of the detrusor nucleus, and then reach the detrusor muscle through the pelvic nerve to inhibit the contraction of the detrusor muscle;

③ The electrical stimulation impulse goes up to the thoracic and lumbar segments, exciting the sympathetic neurons. The α-adrenergic receptors cause the bladder neck and proximal urethra to contract, further increasing the urethral closure function. The α-adrenergic excitement relaxes the bladder base and increases the closure of the bladder neck.

(3) Drug treatment has two purposes:

① Increase urethral resistance: Use drugs to increase the contraction function of the urethra and increase the urethral closure pressure. Such as oral ephedrine;

② Use drugs to increase the tension of the pelvic floor and plump up the atrophied supporting tissue: such as using estrogen. It is suitable for true stress urinary incontinence caused by estrogen deficiency in menopausal women and other reasons. It can cause the epithelium of the urethra to proliferate due to estrogen deficiency, enhance the urethral closing function, and enrich the vascular network under the urethral mucosa, increase the urethral pressure and urethral closing pressure, and achieve the purpose of cure or improvement. Oral estrogen has more side effects. Applying estrogen paste preparations into the vagina can cause proliferation of urethral mucosal epithelial cells.