Effective solutions for incontinence

Urinary incontinence is a very common disorder among women whose prevalence increases with age mainly due to the weakening of the pelvic floor due to age or pregnancy. According to the “I Study on Intimate Health of Spaniards”, 25% of Spanish women have suffered or are suffering from urine leakage.

Specifically, 33% of women between the ages of 36 and 45 have had or have incontinence problems, with the percentage increasing for women over 45 (42%).

There are different strategies to combat urine leakage, from specific exercises until follow treatments pharmacological or undergo certain surgical interventions in certain cases.

There are also systems so that urine losses do not alter your daily routine. The compresses against losses, for example, are products increasingly comfortable, discreet and that in addition care and protect the skin of the intimate area.

But the important thing is to solve the problem and there are effective options to stop losses and prevent them from increasing or becoming more frequent. We explain how to remedy urinary incontinence.

Objective: strengthen the pelvic floor

Many of the incontinence problems They are due to a weakness of the pelvic floor muscles. This supports the lower abdomen –bladder, uterus, rectum, intestines–. Strengthening these muscles by regularly practicing a series of exercises, known as Kegel exercises, helps prevent urine leakage.

How are Kegel exercises done?

At first, to train yourself, you can do them when you go to the bathroom. Then, with practice, you can perform them at any time of the day. Sit on the toilet, start to urinate and go cutting off the flow by contracting the muscles of the genital area. Repeat several times until you have completely emptied your bladder.

This technique is useful only for you to identify the muscles involved, from then on performing the exercises should not imply cutting urine when you go to the bathroom.

The first step is to identify which muscles make up the pelvic floor.

When this exercise is easy for you, it will mean that you have already “mastered” your pelvic floor and then you can start to work the different muscle groups of the pelvic area one by one:

• Urethral sphincter. It is the one that you have exercised in the bathroom to interrupt the output of urine. When you have it well identified, you can contract and relax the sphincter in any situation, without having to urinate.
• Anal sphincter. It is the one you squeeze when you want to hold the exit of a wind.
• Vaginal sphincter. It is the one that you would contract to avoid the exit of a tampon, for example.

Contract each sphincter for 5 seconds and relax for 10 seconds. Repeat 10 times with each of the sphincters. Then contract all the muscles at once and repeat 5 times. You can finish by doing quick one-second contractions and relaxations.

Do Chinese balls help prevent incontinence?

The use of so-called Chinese balls or vaginal cones can help to considerably strengthen the pelvic floor muscles. They are inserted into the vagina and allow normal life. Of course, to notice the results you must use them daily for at least 6 weeks.

• Chinese balls. They consist of two balls attached to each other that weigh less than 100 g. A maximum of 30 minutes a day should be used. By contracting the muscles to prevent them from coming out, they help to strengthen the area.
• Vaginal cones. They work the same as the Chinese balls, but they have different weights, from 5 grams to something more than 50 (the lightest one is chosen initially and, as the pelvic floor strengthens, the next heaviest one is used, until using the 3 or 4 that make up the pack.Generally, they are used twice a day for 15 minutes.And they are usually recommended when the pelvic musculature is poorly toned.

When is the laser recommended for incontinence?

The laser is a fairly simple technique that consists of introducing a very small instrument in the vagina through which the laser light is projected. This increases the temperature of the water around the vaginal cells, which stimulates collagen production and restores firmness to the tissues, thus raising the bladder. Normally you have to do a monthly session for 2 or 3 months and repeat the treatment every year and a half.

It is usually applied in cases of stress incontinence and also mixed incontinence. In the first, the slightest effort, such as laughing, sneezing, running, etc., causes a loss of urine by increasing the pressure in the abdomen and bladder.

Mixed incontinence combines stress incontinence with urge incontinence. characterized by a sudden urge to urinate that occurs because the bladder (detrusor) muscle is more sensitive than normal.

What drugs are there for incontinence?

In urge incontinence, anticholinergic drugs are often used, which delay the detrusor muscle, thus increasing the ability to retain urine. It also can inject botulinum toxin into the bladder to make it stop contracting.

What is “mesh surgery”?

This minimally invasive intervention is done only in cases of stress incontinence when the laser does not give good results or there is a fall (prolapse) of the bladder or uterus. Consists in place a tape or mesh that holds the urethra and bladder as if it were a hammock.

Both in cases of stress incontinence that are treated with laser and in those that undergo mesh implantation surgery normally local estrogens are also given as an adjunct to treatment. These drugs increase vaginal hydration and improve the mucosa and circulation in the area.

What can I do to prevent urine leakage?

With these care and precautions you will reduce the chances of suffering incontinence:

• Stay at the right weight. Being overweight increases the pressure on the pelvic muscles that support the bladder and urethra, which favors urinary incontinence.
• Avoid constipation. Continuous efforts when trying to evacuate can also end up causing urine loss.
• Urinate when you need to. Holding the urge causes bladder distension and loss of muscle tone and elasticity. But don’t go to the bathroom too often either, since then the bladder becomes “lazy”. Over time, you will not be able to retain normal amounts of fluid and the urge to urinate will become more frequent.
• Cut down on certain foods and drinks. Spicy, citrus, fizzy and exciting drinks, such as tea, coffee, chocolate, alcohol, have substances that irritate the bladder, which increases urinary frequency and produces an urge to urinate.

The future: stem cell treatment

The latest research allows us to state that thecell or regenerative therapy is the great hope to end incontinence more easily.

• Stem cells keep the body running every day. Its function is to replace damaged cells with new ones in order to regenerate damaged tissues.. In this way, they keep us healthy and help prevent premature aging.
• To treat incontinence some of these cells are extracted from a muscle or from the fat of the arms. In cases where this is not possible, they can be obtained from the bone marrow.

The idea is that the cells regenerate the tissue on their own.

• Once obtained, they are cultivated for 6 weeks in the laboratory. Then, those stem cells are injected into the wall of the urethra (the urine outlet tube) and in the sphincter muscle. The intervention is ambulatory and lasts between 15 and 20 minutes.
• This way it is possible to regenerate the muscle or muscles that had been weakened and control urine output.

It has been shown that two years after the intervention there is a high success rateboth in women and men, and without serious complications, according to a study from the University of Buenos Aires.

Although it seems to be a real therapy, experts continue to investigate to confirm that this non-invasive solution to incontinence could have a lasting result.