In older men, causes of urinary incontinence and how to treat it

Incontinence is the name of a pathology accompanied by involuntary emission of urine. Requires a complete examination of the genitourinary system. Stress, physical strain, illness are the most common causes of urinary incontinence in men. Treatment will directly depend on provoking factors, the degree of development of a particular pathology.

Classification

Normal urination, timely relaxation or tension of the pelvic floor sphincter should be mechanically controlled by a person, without much effort. The kidneys are the main organ of urine production, giving a signal for the accumulation of urine, entry into the bladder, stretching of the muscle walls in order to expel urine outward as it fills. A similar mechanism should lead to the excitation of receptors in the walls of the bladder, and in humans, to the urge to urinate. At the same time, there is a tension in the muscular detrusor and a weakening of the sphincter of the bladder.

Failure of the normal physiological process in the kidneys and nocturnal enuresis are a common problem in older and pediatric patients.

The risk group includes:

• men after 40 years of age with changes in the prostate;
• women due to gynecological problems or the development of diseases of the genitourinary system (cystitis, pyelonephritis).

Urinary incontinence is not a separate disease. Rather, it is a manifestation of a symptom that clearly indicates pathologies of various origins on the part of the urinary system.

The types of urinary incontinence are distinguished:

• false in case of congenital leakage of urine from the urethra due to exstrophy of the bladder, total epispadias of the urethra;
• acquired due to trauma to the ureter and bladder, formation of a fistula in the urethra.

By type of urinary incontinence, as the condition is called:

• stressful involuntary urination due to increased intrauterine pressure, decreased strength of collagen structures, lack of resistance. There is a discharge of urine in small portions during moments of coughing, laughing and physical exertion;
• mechanical, taking into account the name, caused against the background of fractures of the pelvic floor bones, damage to the sphincter in the postoperative period on the prostate gland;
• paradoxical (senile) in case of overflow of the bladder, excessive stretching of the walls, the reasons for which are: urethral stricture, cancer, prostate adenoma;
• transient with alcohol-induced urinary incontinence, frequent constipation, acute cystitis;
• urgent in case of weak or not expressed urge to urinate, when imperative and imperative urges are observed, i.e. the patient urgently needs to urinate and there is no way to wait.

For any type of development of urinary incontinence in case of overflow of the bladder, even for a short period of time, hyperactivity is observed, an increase in pressure in the urethra. The reasons for this are external stimuli, alcohol, low temperature outside (cold).

Reasons provoking factors

To provoke a violation of the sensitivity of the bladder and urinary incontinence in men can:

• a chronic disease with an inflammatory course in the pelvic area;
• underwent surgery on the peritoneal organs;
• obesity;
• abnormal anatomical position of the pelvic organs;
• low threshold of sensitivity of nerve receptors that can lead to modifications of fascia and pelvic floor ligaments;
• atrophic changes in the genitourinary system;
• deficiency of estrogen in the body;
• injury;
• brain tumor;
• diabetes mellitus;
• multiple sclerosis;
• CNS defect;
• diseases: acute cystitis, specific urethritis, prostate adenoma, prostatitis.

Note! Spontaneous urination is observed in mental, neurological diseases, when the sphincter of the urethra is weakened and controls physiological stool. Causes - stroke, toxic effects of drugs and alcohol, Parkinson's disease, multiple sclerosis

It is with age in men that the sphincter of the bladder greatly weakens, becomes incapable of blocking the flow of the urethra in full. Men feel the urge, but cannot control muscle contractions on their own. In this case, the urethra is partially (completely) blocked, the process of regulating urination is disrupted. Urine flows out uncontrollably even with slight muscle tension.

Often, urinary incontinence in aged men is due to a urological disease that was treated in childhood, but not thoroughly. A man tries to restrain the sphincter, but cannot avoid urine leakage, so he often simply does not have time to reach the toilet. Desires arise spontaneously, suddenly, or vice versa, become false even in the case of an overflowing bladder.

IMPORTANT!Prostatitis is the most common disease that causes urinary incontinence in older men. The appearance of unpleasant symptoms should be the reason for an urgent appeal to urologists

Diagnostic measures

It is important for a doctor to know in order to make the correct diagnosis and prescribe an appropriate treatment: what kind of lifestyle the patient leads, how much fluid he consumes per day. We study the history of urinary incontinence in elderly men, at what hours of the day or night there is involuntary urination and what is the frequency per day, the strength of urine flow.

In progress:

• urodynamic tests to check the working condition of the urethra, bladder;
• urinalysis to identify the composition, possible damage by bacteria;
• cystometry for detecting quantitative indicators of urine, pressure in the bladder cavity when filling with urine;
• uroflowmetry to determine the degree of bladder function;
• electronic tests to measure urine flow rate;
• cystoscopy or urethrocystoscopy by identifying problems in the lower urinary tract, urethra and bladder, the degree of enlargement of the prostate gland, possible obstruction of the bladder neck, accumulation of calculi;
• electromyography - testing the sphincter if there is a suspicion of a malfunction of the nervous system that can lead to urinary incontinence;
• Ultrasound to detect structural problems and abnormalities in the bladder by feeding a transducer, placed in the lower abdomen.

Often, doctors use a non-invasive research method by inserting a catheter into the urethra, leaving it for a few minutes to remove urine. After that, the residual volume of urine after urination is measured. If the volume exceeds 200 million, then this is already considered a pathology.

Healing actions

If urinary incontinence is detected in elderly men, then treatment is prescribed:

• surgical;
• conservative;
• folk as an addition to therapeutic methods.

Conservative therapy is prescribed after an operation to remove the bladder or prostate. Medicines are useful for involuntary emptying due to neurological disorders or the development of diseases.

Patients need:

• radically reconsider your lifestyle;
• give up bad habits;
• observe special meals;
• carry out preventive exercises to eliminate discomfort when urging to use the toilet;
• normalize sleep, sleep at least 8-9 hours.

Note! Men aged with urinary incontinence need to limit fluid intake per day. The dose should not exceed 2.5 liters, and it is advisable to take water in small portions. It is worth excluding harmful products from the diet that can negatively affect the muscle tone of the urethra (smoky, salty, pickled)

Taking into account the identification of another disease, urinary incontinence is treated with medications:

• antibiotics, drugs for damage to the kidneys, urethra by bacteria;
• antispasmodic drugs to eliminate the unpleasant consequences of involuntary urination;
• antidepressants (imipramine, duloxetine);
• hormone pills.

Note! The drug Driptan for urinary incontinence in men can quickly help men of age eliminate any type of urinary incontinence. The drug actively affects nerve impulses, sends signals to the brain, leads to a weakening of the sphincter and muscle muscles of the bladder, normalizes the volume of urine production, eliminates sudden urge to urinate, and reduces the number of trips to the toilet.

Physiotherapy helps a lot: electrical stimulation, magnetotherapy, radon baths.

Surgery

The operation is prescribed when conservative treatment of urinary incontinence in elderly men does not bring positive results and drugs are powerless.

Taking into account the form and stage of development of the pathology, it is possible to carry out:

• a plastic method by introducing an artificial implant into the bladder, replacing a non-functioning organ with a plastic prosthesis;
• transurethral with the use of a gel, introduction into the urinary canal, in particular for urgent urinary incontinence. The method helps to eliminate sudden urge, normalizes the control of urination;
• slang method by introducing a special loop under the lower part of the urethra to support the pelvic floor, relieve pressure on the bladder wall.

In the treatment of urinary incontinence in the elderly, catheterization of the insertion of a catheter or a special balloon is widely practiced in order to expand the urethra, ensuring the timely removal of urine from the bladder in full.

Folk recipes

Some plants, when treated, can become an additional tool for relieving inflammation and enhancing immunity. Of course, urinary incontinence is a serious pathology in older men and it is unlikely that decoctions, infusions will help to achieve sustainable results.

Self-medication with herbs is excluded! Although only with the permission of the attending physician, you can combine medicinal preparations with useful herbal infusions: lingonberry, yarrow, sage.

It is important to understand that, for example, prostatitis, which leads to urinary incontinence, is treated exclusively with medications. If the operation becomes an extreme measure, then men should not refuse when the drugs are almost powerless.

Kegel Exercises

The non-invasive Kegel method is recommended for men to train the pelvic floor muscles, normalize symptoms in older people who have been experiencing urinary problems for many years.

Exercise is capable of:

• strengthen in one place and keep the bladder in shape;
• close the sphincter promptly after emptying;
• train your pelvic floor muscles;
• normalize urination every 3-4 hours.

With daily and correct procedures, the results will be noticeable in 3-4 weeks. The leakage of urine in the morning hours, during exertion or physical exertion will disappear.

For prevention purposes, men can only recommend:

• keep the skin clean;
• avoid any irritation of the genitals, infection of the skin around the urethra;
• take an exceptionally warm shower, refuse a bath, steam room;
• use a protective moisturizer after bathing to avoid irritation in the anus;
• track your weight;
• avoid constipation, include fiber-rich foods (fruits, vegetables) in the diet;
• drink enough fluids.

It is a myth and misconception that men believe that drinking a lot of water contributes to urinary incontinence. This is a weakening of the sphincter and the dose of fluid has nothing to do with it. Although, of course, you should not get drunk before bed and try to urinate at night.

Often men are in no hurry to see a doctor because of shame, any personal convictions. But it is urinary incontinence in old age that actually leads to disability. Today, many modern methods (minimally invasive, non-invasive) are known that can normalize the condition of the bladder, eliminate signs of incontinence.