Treatment of enuresis in the elderly. The most effective treatments for urinary incontinence in older women. Why is incontinence so common in old age?

04.07.2020

Problems of spontaneous urine flow affect half of women aged 60-70 years. This manifestation has a negative impact on all aspects of life, causes serious psychological disorders, and violates social adaptability. Very often leads to severe and prolonged depression.

Often, uncontrolled urine output is associated with chronic infectious diseases, a bedtime lifestyle, the formation of pressure ulcers and the constant presence of a urinary catheter.

The main reasons also include:

increased body weight;
surgical interventions on the small pelvis;
caesarean section, birth injuries;
diseases of the nervous system;
neurological ailments;
weakness of the muscular apparatus.

A malfunction of the urinary system can also cause diabetes mellitus of the second and first types, cerebrovascular accident (stroke), excessive physical work and tobacco smoking.

The pathogenesis of disorders in elderly women is based on atrophy of the muscular apparatus of the pelvic region and urethral sphincters. With changes in the anatomical structure, the compression and extensibility of the sphincters is disturbed, as a result of which it becomes difficult to control the urge to urinate.

Urinary incontinence in women after 70 years is divided into true and false. With true incontinence, urine is excreted naturally, along the anatomically correct urethra. This pathology occurs most often.

False develops when the location of the pathways for urine excretion is disrupted, or their injury. It occurs in only 10% of women. Also, incontinence is divided into four types:

Iatrogenic type - the type of illness, which is preceded by the uncontrolled intake of various medications. These include hormonal and diuretic drugs, as well as antidepressants.
Imperative type - Excessive stressful activity before and during retirement age is causal. With this type, even a small portion of urine in the bladder can lead to an immediate urge.
Stress type - manifests itself through weakening or malfunctioning of the urethral sphincters and, in case of a stressful situation, will provoke the release of urine.
Enuresis - Excretion of urine during sleep, without urge.

Also, women in old age may experience urine leakage - after the process of urination, there is a slight leakage of urine.

Video: Urinary Disorders in Women

Basics of pathology diagnosis

Before prescribing treatment, it is necessary to establish the exact cause of the appearance of this ailment. During the appointment, the doctor must interview the patient and collect a history of life and illness.

It is necessary to establish whether this pathology is hereditary, when this symptom first began to appear, whether cases of uncontrolled discharge have been progressing in recent years and what causes this condition is provoking.

For convenience, a woman is offered to undergo a special questionnaire, which indicates the frequency of urges, how long it is possible to control them, whether it affects social aspects, whether they are disturbed during sleep.

If this survey is not enough to establish a clinical diagnosis, they resort to laboratory and instrumental diagnostic methods.

Laboratory methods include:

General urine analysis - suggests an infectious disease of the urinary system. An increased number of leukocytes, proteins, traces of mucus and bacteria are detected.
A complete blood count - the level of leukocytes and the acceleration of ESR, which may indicate the presence of an infectious agent.
- determination of shaped elements per unit volume.
PAD test - a special pad is used, with which you can determine the amount of urine released per day.
Hormone levels - allows you to determine the hormonal imbalance in the body.

Among other methods, one should not forget about a banal gynecological examination. During the examination procedure, it is possible to reveal prolapse of the uterus and vagina, dryness of the walls, endometriosis, and an oncological process.

In the case of a more serious pathology, they resort to instrumental methods:

ultrasound examination of the genitourinary organs - it is possible to assess the size of the kidneys, their shape, thickness and structure, the size of the bladder, the condition of its walls, the diameter of the ureters
cT scan - visualize kidney tissue, calyx-pelvic structures, ureters and bladder, covers the small pelvis, abdominal cavity;

If necessary, the cystoscopy method is used. This method evaluates the inner wall of the bladder.

It is not easy to cure this ailment, but it is possible. The most effective treatment will be to get rid of the root cause of the disease. The therapy will be different for every elderly patient.

Conservative therapy will include a variety of therapeutic exercises, drug therapy, massage of the pelvic area, diet therapy, getting rid of bad habits, various psychological trainings, as well as various combinations of these methods.

It is necessary to include Kegel exercise. The developed exercises include several steps that help strengthen the pelvic floor muscles. This technique is considered an excellent addition to traditional treatment.

When doing the exercises, you need to make special preparation, empty the bladder, take a comfortable position, do not rush and do not increase the complexity of the exercises. It should be understood that the exercise should be performed systematically, otherwise the long-awaited effect will be difficult to achieve.

The workout includes:

Contraction of the muscles of the pelvic region.
Pushing or pushing.

When carrying out drug therapy, various groups of drugs are used, depending on the identified cause. This method of treatment can help 80% of women, if you follow all the doctor's recommendations, exercise systematically and take appropriate therapy.

The groups of medicines used in treatment include:

Antidepressants - are prescribed if the cause is frequent stress.
Estrogens - are used in case of deficiency of female sex hormones, estrogen and progesterone.
Sympathomimetics- leads to compression of the muscular apparatus, which performs the function of contraction during urination.
Desmopressin - reduces the formation of urine.
Anticholinergics - help to relax the walls of the bladder, which increases the amount of urine in it and controls urination.

Surgical treatment is used only if conservative methods have failed. Most often, operations are performed to normalize the architectonics and the correct anatomical position of the organs of the urinary system.

This method includes the following manipulations:

Colposuspension - anastomoses the tissues near the urethra to the comb ligaments.
Sling operations a special mesh is inserted under the bottom of the bladder, in the form of a loop, which keeps the urinary tract in a physiological position.

These techniques also include bulking agents injections. A specific drug is injected into the submucosal layer of the urethra, which replaces the missing tissue of this organ.

Non-traditional treatment should only be resorted to after detailed consultation with your doctor. Most often, various herbal decoctions, tinctures, compresses are used.

There are many homemade recipes for various remedies.

You can take 10 parsley seeds, a couple of hop cones, lovage root, and beans. Brew 30 grams of the mixture in 300 ml of boiling water, drink during the day.

It is also recommended to take juice from the squeezed plantain leaves 3 times a day, one 10 ml. The tincture of these leaves will also help, it is necessary to brew ten pieces in a glass of boiling water and drink 4 times a day for a quarter of a glass.

You can brew 10 grams of dill in a glass of boiling water, leave for an hour, take during the day.

Pour a portion of bark and 20 grams of aspen twigs with boiling water, boil for 50 minutes. Take half a glass three times a day.

Brew four bunches of leaves and a handful of lingonberries in 400 ml of boiling water. Insist until the liquid ferments. Drink 3 times a day.

Video: Urinary incontinence in adult women

Urinary incontinence refers to diseases of the urinary system that are often diagnosed in older women.

The pathological process causes not only physical but also psychological discomfort. That is why it is necessary to timely treat pathology.

Causes and risk factors

At the age of 40-50, women experience muscle weakening. The bladder is characterized by loss of muscle elasticity. This is why he cannot hold a sufficient amount of urine. Women of advanced age are at risk. This is due to the fact that, against the background of hormonal changes, the occurrence of atrophic changes in women is observed. The main causes of senile urinary incontinence are:

There are many causes of urinary incontinence in old age. That is why the patient must do everything possible to eliminate them.

Diagnostics

The primary diagnosis of the disease is carried out using a cough test. If the patient has urine secretion, then the sample is positive.

To confirm the preliminary diagnosis, the patient is recommended to take blood and urine tests.

The fairer sex is prescribed a microscopic examination of smears. To determine the cause of the pathology, an ultrasound examination of the pelvic organs and kidneys is performed.

Patients need to keep a diary in which they should constantly record the number of urinations and uncontrolled urine flow. It is necessary to record in the diary what drugs were taken by the patient, as well as food.

Diagnostics is a rather important aspect in the treatment of a pathological process, therefore, this stage must be treated responsibly.

Conservative treatment

In most cases treatment of urinary incontinence in older women carried out using conservative methods. To speed up the process of treating pathology, patients are prescribed diet therapy. The choice of certain drugs is carried out in accordance with the individual characteristics of the patients and the severity of the course of the disease.

Drug therapy

If women experience the development of a pathological process during menopause, then she is prescribed drug therapy. By restoring the amount of estrogen in the blood, the vaginal tissue is improved.

If there are contraindications to taking hormonal pills, women are advised to use a special cream, which is developed on the basis of estrogen. It is characterized by a local effect of exposure and is not able to penetrate into the bloodstream.

For the treatment of urinary incontinence, which strengthen the sphincter and bladder muscles:

Duloxetine;
Imipramine;
Midodrin;
Methoxamine;
Ephedrine;
Clenbuterol.

In some cases, doctors prescribe drugs that reduce the amount of urine produced.

If the disease occurs against the background of taking antihistamines, sedatives, as well as stimulants, then they are canceled.

Bladder training and exercise

For the treatment of the pathological process, it is recommended to use special ones that will help strengthen the muscles of the bladder. They are carried out according to a special technique. In the first few days of the class, it is recommended to visit the toilet on a schedule. It is recommended to empty the bladder every hour, even if there is no urge.

After a few days after doing the gymnastics, the intervals between urination can be increased. This schedule is supposed to be maintained throughout the week. In order to strengthen the pelvic muscles, Kegel exercises are recommended:

Exercise will enable the bladder to hold urine for 4 hours.

Laser therapy

If drug treatment does not bring the desired results, then the use of laser therapy is recommended. Treatment senile urinary incontinence in women, it is performed using an erbium laser.

It is characterized by an effect on the anterior vaginal wall, which leads to the activation of the growth of collagen fibers. By reducing the mobility of the bladder, it can retain urine for a longer period.

Laser treatment is painless and therefore does not require anesthesia. Before the procedure, the need for a special preparatory period is excluded. The duration of the manipulation is 20-60 minutes. To obtain the highest possible effect, the patient is recommended to carry out two treatment sessions.

Operative treatment

In severe cases, patients are recommended to undergo surgical intervention. Most often in this case, it is recommended to use the gel technique. It consists in the introduction of a biopolymer gel into the submucous layer of the urethra.

With its help, the narrowing of the urethral lumen is carried out, which will lead to the elimination of the possibility. It is recommended to use local anesthesia for surgical intervention.

During surgery, a cystoscope is used to monitor its progress.

To combat a pathological process called a synthetic loop. It consists in the introduction of a polymer loop under the layer of the urethra. It creates additional support for the bladder.

Herbal treatment

Traditional medicine is highly effective in urinary incontinence. In most cases, herbs are used to combat the pathological process, which are as safe as possible for the human body.

To eliminate the pathological condition, it is recommended to take a decoction, which is prepared on the basis of plants such as St. John's wort and lingonberry:

It is necessary to take, as well as the ground part of St. John's wort in the same amount. All components are crushed.
Two tablespoons of the resulting raw materials are poured into a glass of boiling water. Next, the medicine must be boiled over low heat for 10 minutes. After cooling, the broth must be filtered and taken orally three times a day.

How to prevent disease and prevent complications from developing

In order to avoid the course of a pathological condition, it is necessary to carry out its prevention in a timely manner, which consists in fulfilling certain rules:

Timely and complete emptying of the bladder is recommended for people who are at risk.
It is recommended to refuse products that include a large amount of sugar. The consumption of citrus milk and tomatoes is not recommended for patients.
Unbearable physical labor, as well as heavy lifting, is strictly prohibited for patients.
Restricting fluid intake is strictly prohibited. If it is insufficient, there will be an excessive concentration of urine, as well as increased irritation of the bladder. If the symptoms of the disease are observed during sleep, then patients are advised to reduce the amount of food consumed in the evening.
It is recommended to refuse strongly scented and colored hygiene products.
If a person is overweight, then it is necessary to deal with it with the help of diet therapy and exercise.

Senile urinary incontinence is a rather serious pathological process that requires complex treatment. It should be developed only by a doctor after conducting appropriate examinations.

Age gives a person a lot of trouble - more and more often health fails, because the state of the body is already far from its parameters in youth. One of the most uncomfortable troubles that occurs in old age can be safely called. For what reasons does it arise? Are there any ways to get rid of it? Is it possible to protect yourself from this ailment at a young age? We will try to answer these and other questions further.

Why is incontinence so common in old age?

The main cause of urinary incontinence in old age is the gradual wear and tear of body tissues.

Due to aging, the process of cell death is triggered, which leads to the fact that certain organs can no longer fully perform the functions assigned to them. Eventually, in older people, the sphincter weakened, no longer able to fully withstand the pressure of urine. In addition, in old age, large deposits of fats and salts appear on the bladder, which block its normal functioning. This only enhances the already not the best state of the body's excretory system in the declining years, which provokes urinary incontinence in the elderly.

For women, in addition to all of the above, menopause is an additional problem in old age. Hormonal changes in the body lead to the fact that the organs receive an insufficient amount of collagen - the main element that contributes to the preservation of tissue plasticity. This increases the general weakness of the sphincter and bladder in old age in women.

Older men have another problem - a possible one. This condition causes the prostate gland to enlarge and interferes with the normal urination process. Thus, fluid accumulates in the bladder, and when it is full, it spontaneously flows out. Adenoma is more likely to occur in men after the age of sixty.

Diseases that can cause incontinence

Studies show that the most common cause of incontinence in the elderly can be diseases that lead to muscle strain. One of them is the most common cough - even a banal strong coughing can provoke an attack of spontaneous urination.

However, there are more serious conditions that increase the risk of bladder problems. These include - one of the most common hormonal ailments. Diabetes can be triggered when the disease is caused by a loss of insulin sensitivity in the body's cells. In this situation, the patient's body will lose eight to nine liters of urine per day. For people of age, the problem is aggravated by the fact that the tissues lose their elasticity, as a result of which the sphincter cannot constantly restrain such frequent urges to use the toilet. That is why diabetes mellitus in the elderly can occur.

Another ailment that causes incontinence is Parkinson's disease. It causes a disorder in the functioning of the muscular system, due to which the human body does not always adequately and in time respond to its needs. General muscle stiffness leads to the fact that the sphincter does not respond to the urge to urinate, which becomes the cause of spontaneous emptying of the bladder.

Unfortunately, this disease is chronic, and therefore no therapeutic procedures have yet been developed to eliminate its uncomfortable consequences.

Why is incontinence dangerous? What can it lead to?

Problems with involuntary urination in old age can cause some complications and side effects. First of all, it is necessary to mention the emotional aspect: incontinence leads to the appearance of oppression, depression, depression. People suffering from this ailment decrease social and labor activity. Incontinence reduces the independence and mobility of older people.

Long-term problems with spontaneous urination, in the end, can result in catheterization - the introduction of a special excretory tube into the bladder, which is designed to drain urine into a separate bag for collecting fluid. The danger of this procedure is that it can increase the risk to which the human body is especially exposed in old years.

Gradual muscle wasting, one of the most common causes of incontinence in older people, can also cause problems when walking. People with this weakness will have difficulty walking with the same coordination and speed as in youth. With this in mind, problems with the muscles of the go and sphincter can result in bruises and injuries during falls.

Diagnosis of the causes of the disease: who to contact, and what tests need to be taken

Urinary incontinence in the elderly will help to diagnose correctly.

To begin with, he will need information about your lifestyle, the amount of fluid you drink per day, as well as other problems with the genitourinary system that you may have had in the past. Next, the specialist will need your medical history, from which it will be necessary to find out facts about the present and past physiological indicators, as well as about the urgent nature of urination.

First, tell your doctor when you started having incontinence problems, the frequency of going to the toilet, the daily fluid intake, the frequency of spontaneous urine leaks (especially at night), and your favorite medications you are currently using.

The most effective and common of them are:

cystometry (determines the volume of fluid contained by the bladder and the pressure that this organ experiences when filling. During this procedure, the patient will be inserted one or more catheters, with the help of which the process of passing the test will be faster and more efficient);
uroflowmetry (this electronic test will quickly help detect various difficulties during urination by measuring the flow rate of urine. The patient will only need to urinate into a special device that will detect deviations from the expected rate of fluid emission)
cystoscopy (This test is used to identify problems in the lower parts of the urinary tract - the urethra and the bladder. The procedure involves the introduction of a thin tube with a microscopic flashlight at the end into the bladder through the urethra. Cystoscopy helps the urologist determine if there are significant problems with the excretory system - prostate gland, distension of the urethra, the presence of kidney stones .. Moreover, the extreme efficiency of the procedure even helps to identify the first signs of bladder cancer, which practically guarantees its successful cure).

As a rule, these tests are effective - the specialist is able to determine the cause of the incontinence and prescribe the appropriate treatment, and therefore it is not worth delaying the diagnosis.

You can protect yourself from incontinence in old age even in young years.

Health professionals claim that urinary incontinence in the elderly - this is a problem, the preconditions for which are formed at a much earlier age.

To reduce the risk of problems with the doctor, it is advised to adhere to certain rules.

Firstly, even in youth, you need to consume less various drinks with a high content of chemical additives - their ingestion ultimately leads to a weakening of the excretory system and its gradual degradation.
Secondly, you need to actively engage in physical exercises - even the simplest gymnastics will help keep the muscles in good shape and prevent the loss of their elasticity in old age.
And, finally, thirdly, special care is required in the cold season - viral infections arising from hypothermia of the body in young years can respond with a series of unpleasant complications (including with the urinary system) in old age.

Medical approaches to the treatment of senile urinary incontinence

Medicine that has advanced far today offers several ways to get rid of urinary incontinence in the elderly. The following methods have already proven their effectiveness:

Taking antibiotics (Recommended if urinary tract infection is the cause of incontinence. Antibiotics help get rid of the problem in a short time).
The use of drugs of the anticholinergic group (they are required when urination problems cause an imbalance in the nervous system).
Surgical intervention (It is prescribed as a last resort. In this situation, operations are performed on the bladder, kidneys or urinary tract).

Folk remedies for combating incontinence in the elderly

Traditional medicine also does not stand aside - methods of getting rid of incontinence among the people have existed for a very long time. As practice shows, their effectiveness is also very high. It is worth mentioning the following folk remedies:

bath with pine branches and spruce cones (useful for the kidneys and urethra, strengthens the circulatory system, has a beneficial effect on the skin, it should be taken for twenty minutes);
hay bath (strengthens the bladder, eliminates infections of the genitourinary system, the duration of admission is the same - twenty minutes).

If you wish, bathing can be replaced by rubbing with tincture of oat straw or fir cones - the result will also be noticeable. It is also recommended to take decoctions, the most effective of which are based on St. John's wort or yarrow.

Special urinary incontinence exercises for people aged

Strengthening muscles is called the first step to get rid of urinary incontinence in the elderly. The gymnastic complex is not particularly difficult and does not require a lot of time to perform it.

Here is a list of the most effective exercises that can significantly strengthen the muscles of the body:

Walking in place while lying down.
"Bicycle" (rotation of imaginary pedals).
Wave arms and legs.
Walking in place.

Experts say that any of these treatment options can be used to treat incontinence. Do not worry - this ailment lends itself to effective treatment.

VIDEO Elena Malysheva. Causes of urinary incontinence

VIDEO Live great! Pelvic floor simulators for urinary incontinence (2014.2014)

Most older women are familiar with the characteristic symptoms of incontinence - urination that is uncontrollable by willpower. About 80% of patients who have entered menopause suffer from urinary disorders. Not all the fair sex seek help from a doctor, exacerbating the situation and provoking the development of complications.

Classification of urinary incontinence:

False. This is involuntary urination due to congenital or acquired defects of the urethra, bladder, or ureter (eg, total epispadias of the urethra, trauma from a urinary fistula, or ectopia of the ureteral orifice).
True (not related to the presence of gross defects).

Causes and factors provoking development

Urinary incontinence in old age is a commonly diagnosed ailment for women. The causes of senile urinary incontinence lie not only in age-related changes in the body. There are several types of urinary disorders, each of which has a certain basis:

Stress incontinence. Symptoms of this pathology can be seen during physical activity, as well as sneezing and laughing. In older people, the problem occurs in 30-40% of cases;
Imperative or urgent incontinence. Manifestations of this type of disease are familiar to 15 - 20% of people. The disorder is a consequence of an increased tone of the bladder. Pathology is adversely affected by external irritating factors, for example, the sounds of pouring water, cold air temperature, the use of strong drinks, etc.;
Involuntary urine production of a temporary nature (transient).

If an elderly person has symptoms of a similar disorder from time to time, it is advisable to do an analysis. This is necessary in order to identify an infectious and inflammatory lesion that has affected the bladder or urethra - the urethra. In older women, urge to urinate can also be associated with vaginal inflammation and is usually accompanied by a burning sensation.

The consequence of the transferred diseases of the genitourinary system can be enuresis - urinary incontinence, which manifests itself during sleep. Severe emotional upheaval and some pathologies of the central nervous system also lead to a disruption of excretory function: Parkinson's disease, stroke.

Women who have entered menopause can face the disease due to a decrease in the amount of estrogens - female sex hormones produced by the ovaries. Hormonal imbalance provokes atrophic changes in the cervix and urethra tissue.

Involuntary discharge of urine may be the result of a mechanical obstruction to its normal outflow. Tumors and calculi located in the bladder or urethra can cause an imbalance in urinary function

Some habits of risk factors contribute to the development of the disease:

Regular consumption of carbonated and caffeinated beverages.
Insufficient amount of coarse fiber food in the diet and, as a result, frequent constipation.
Hormonal changes in the body associated with menopause.
Hereditary predisposition.
Engaging in certain sports.
Chronic inflammatory process in the pelvis.
Smoking and accompanying cough.
Decreased overall muscle tone.
Gynecological surgery.
Rapid, protracted or traumatic labor.
Diseases of the upper respiratory tract.

Therapeutic course

It is especially difficult to control incontinence in very old people. In old age, all systems of the body weaken, the protective function of the immune system decreases. Aging is not spared and the bladder: the tone of its muscles weakens, and the walls of the organ thicken, losing the ability to stretch.

For treatment of age-related urinary incontinence in women to be effective, it is necessary to visit a doctor and pass the necessary tests

Hormonal insufficiency leads to a decrease in the tone of the bladder, so the body loses its ability to maintain a normal amount of urine. Urinary upset in older women can occur due to prolapse and sagging of the urethra, because a lack of female sex hormones can also affect the urethra. To eliminate a delicate problem, the doctor selects special drugs that help restore estrogen levels.

Relaxing agents and laser treatment methods that do not require hospitalization or a rehabilitation period help to cope with the pathology. The laser correction is carried out within half an hour, it helps to strengthen the collagen of the vaginal tissue and quickly eliminate the symptoms of the disease.

Treatment of chronic diseases requires regular pills, which are often the cause of incontinence symptoms. Such a side effect is observed from antihistamines, diuretics and sedatives. Severe urinary disorder may disappear after inappropriate medications are discontinued.
If pathogenic microflora contributes to the development of incontinence, antibiotic therapy is indicated.

Exercise complex

There are special exercises designed to solve a delicate problem. Do not forget that gymnastics must be done regularly, otherwise the long-awaited relief may not come.

Female urinary incontinence is corrected by alternately contracting and relaxing the muscles that support normal urination. This technique is called Kegel gymnastics. Performing exercises daily, the first results can be noticed after a month. The duration of the full course of studies is about 6 months.

Herbal treatment

Many women, faced with the first symptoms of an ailment, try to treat incontinence on their own. Recipes of traditional medicine complement well physiotherapy and drug treatment, but it is not recommended to use them without the consent of the attending physician and until the causes of the pathology are clarified.

A decoction of lingonberry leaves and St. John's wort helps to eliminate the disorder of urination that occurs during menopause. To prepare it, you need 2 tbsp. l berries and leaves of lingonberry and 2 tbsp. l dried St. John's wort. The resulting mixture is poured with 3 glasses of water and boiled for 10 minutes. Filter herbal broth and drink 3 times a day before meals.

Lingonberry leaves are rich in phytoncides - active substances that have a detrimental effect on microorganisms that cause bladder disease

Surgical methods

In some cases, medications do not bring the expected effect and the woman's quality of life continues to decline. If this happens, it is necessary to pay attention to other methods of treating the disease, for example, to modern surgical methods (fixing the pelvic floor using synthetic materials, eliminating anatomical defects, etc.).

Relaxation of the sphincter of the bladder, resulting from the formed stones, does not lend itself to conservative treatment. The tablets will not restore normal excretory function until the neoplasms are removed.

How to prevent the disease and prevent the development of complications

To prevent the symptoms of pathology from affecting the normal rhythm of life, older women should carefully monitor the state of the body. Preventive recommendations will help to avoid problems with urinary function:

The bladder must be completely and timely emptied, even if there is no urgent need to visit the restroom.
Foods containing a large amount of sugar do not have the best effect on the functioning of the excretory system. Tomatoes, citrus fruits and milk have a similar effect.

Alcohol is irritating to the bladder, so beverages containing alcohol should be excluded from the menu

Lifting weights and excessive physical labor should be avoided.
You can not limit the amount of fluid consumed. Some women drink very little water, hoping that such a measure will help to avoid frequent urination. However, dehydration will have the opposite effect - urine will become concentrated, which means that bladder irritation will increase. The likelihood of developing a bacterial infection will also increase. If symptoms of incontinence occur mainly during sleep (enuresis), you can reduce the amount of fluid you drink at night.
Hygiene products (soap, toilet paper, bath fillers) should not be colored and highly flavored.
The pressure exerted on the urinary system is often associated with the acquisition of excess kilograms by a woman. Having lost excess weight, patients often notice significant relief.

Summary

Any type of urinary incontinence requires proper treatment. The causes of the pathology are varied, so it is impossible to independently select a therapeutic course. Only a specialist can prescribe drugs or recommend surgery, having collected a complete medical history.

From senile enuresis affects up to 60% of people who have crossed the 75-year-old threshold. Pathology is equally observed in people of both sexes. In this article, we will examine the main causes and methods of treating urinary incontinence in older women.

Urinary incontinence refers to the involuntary discharge of urine from the urethra.

Table 2. The main types of urinary incontinence in an elderly woman.

Type of enuresis	Description
	Involuntary urination due to pressure on the abdominal wall. "Trouble" happens against the background of heavy lifting, laughing, sneezing or coughing.
	Allocation of a small portion of urine occurs immediately after the onset of the urge to urinate. Usually a few drops of urine are released. Less often, the emptying of the bladder is complete.
	A person cannot control urinary retention. The process of urination occurs both during the day and at night.

The incidence of senile enuresis is shown in the diagram.

Risk factors

The main reason for the development of enuresis in the fair sex is the relaxation of the urethral muscles.

The walls of the urethra become less elastic. The muscles that hold the bladder are weakened. Other causes of urinary incontinence are indicated on the plate.

Table 1. Risk factors.

Factor	Description
	Enuresis can be given from mother to daughter.
	Pathology progresses against the background of the development of adhesions, disruption of the rectum, uterus and urinary system.
	The disease is provoked by an overdose of diuretics, long-term use of antidepressants, sedatives, and alpha-blockers.
	The risk group includes women with a 3-4 degree.
	The risk group includes smokers who have been working for 30 years or more. The "smoker's cough" can act as a provocateur.
	Self-control to urinary act is lost in the presence of multiple sclerosis and dementia.

Note! Problems with stools also adversely affect the state of the urinary system. Incontinence occurs in women with "chronic" constipation.

The diagram shows the diseases against which senile enuresis develops.

Characteristic symptoms

The main symptoms are presented in the plate.

Table 3. Symptoms of urinary incontinence in the elderly.

Symptom	Description
	It occurs against the background of even the smallest physical activity.
	Involuntary urination occurs with a half-empty bladder.
	At the same time, involuntary discharge of feces can be observed.
	The woman tries to leave the house less often, because she is afraid of "embarrassing herself" in public.
	The desire to go to the toilet is observed against the background of the appearance of harsh sounds, bright light, or noisy pouring water.

Degrees of incontinence

The following degrees of senile enuresis are distinguished:

drip - up to 50 ml;
light - 50-100 ml;
medium - 100-200 ml;
heavy - 200-300 ml;
very heavy - from 300 ml.

How can you help?

Treatment of urinary incontinence in older women involves:

taking medications prescribed by a doctor;
use of special gaskets;
doing exercises.

In the most difficult cases, the doctor decides on the surgical intervention.

Carrying out drug therapy

The following medicines are used to treat urinary incontinence in older women:

antispasmodics;
antidepressants;
drugs to increase the volume of the bladder.

The use of antispasmodics

The drugs of this group help to stop inflammatory processes in the organs of the genitourinary system, increase the time interval between the processes of urination.

A drug

Description

Price

M-anticholinergic from the group of tertiary amines.

Helps to eliminate spasms and reduce the tone of smooth muscles.

Also, the medicine accompanies the relaxation of the detrusor of the bladder, the reduction of spontaneous contractions of the detrusor, increases the capacity of the bladder.

732 rubles.

It has an antispasmodic and myotropic effect.

678 rubles.

The most effective drug in the antispasmodic group is Spazmex.

The use of antidepressants

Medications from this group are prescribed for stress incontinence. Taking antidepressants helps to relax the nervous system.

Table 5. The most effective antidepressants.

Medication	Description	Cost
	The medicine has a powerful antidepressant effect.	487 rubles.
	Tricyclic antidepressant with thymoleptic, antidysuric, antidepressant, psychostimulating effect.	394 rubles.

Note! Antidepressants cannot be taken alone.

Drugs to increase the volume of the bladder

As the volume of the bladder increases, its ability to retain urine increases.

Medicine	Description	Cost
	The medication helps to reduce the tone of the smooth muscles of the urinary tract.	359 rubles.
	Blocker of m-cholinergic receptors localized in the bladder.	From 214 rubles.

The drugs, the active ingredient of which is tolterodine, have a powerful effect.

The use of special gaskets

One of the most effective remedies for involuntary urination is urological pads. They differ in the degree of absorbency.

Table 7. Pads for older women with urinary incontinence.

Product	Description	Cost
	German products. The product has a 3-layer texture. The antibacterial effect is provided by the acidic pH. The upper layer of the product is made of natural cellulose, due to which the development of an allergic reaction is stopped.	Up to 380 rubles.
	Swedish products. These pads are suitable for drip and medium incontinence. The main advantage is blocking the unpleasant "odor". The pads are excellent at absorbing moisture, thereby providing comfort and dryness.	Up to 400 rubles.
	Hygiene products are made of high quality absorbent material that has a binding capacity. The liquid is evenly absorbed and does not cause any discomfort.	120-200 rubles.

Exercise

When treating urinary incontinence in older women, it is recommended to perform. The main objective of the training is to restrain urination.

An exercise	How to perform?	How many times to repeat?
	It is recommended to take a horizontal position. Then you need to strain and relax the muscles that are responsible for controlling the urinary process. Squeezing the desired muscle, you need to wait 3 seconds. The interval should be gradually increased to 20 seconds.	10.
	The first exercise is performed at a faster pace.	10.
	Muscles are tense, which work when a person has a desire to empty the bladder.	10.

Note! Training is an additional therapeutic method. It is carried out in parallel with drug therapy. The average duration of the course is 90 days. All exercises are performed 5 times / 24 hours.

"Grandma's" means

Treatment of urinary incontinence in elderly women with folk remedies is carried out only under the supervision of a doctor.

Means	How to cook?	How to apply (times / 24 hours)?
	20 grams of the main ingredient is mixed with 175 ml of boiling liquid. Infused for 150 minutes, well filtered with gauze.	1. The medicine is drunk in one gulp.
	20 grams of berries are mixed with the same amount of hypericum. Then the mixture is boiled in 300 ml of water, cooled, well filtered.	Every hour, starting at 16:30, until lights out.
	The main component is well crushed, mixed with 180 ml of cooled boiling water, infused for up to 10 hours.	2.
	30 grams of medicinal herb is combined with 1000 ml of the coolest boiling water, cooked for 7 minutes, filtered, divided into 3 equal parts.	3.
	The fruits of the plant are combined with foxglove in proportions of 4 to 1. The product is boiled for 35 minutes, then rosehip branches are added to the saucepan. Next, the medicine is boiled twice more for 30 minutes, is well filtered.	2-3.

Operative intervention

How to cure enuresis if drug therapy is powerless? The woman is assigned an operation.

Surgery is usually done for stress incontinence. In some cases, it is prescribed for urgent enuresis.

Table 10. Types of surgical intervention.

Operation	Description	Success
	Bioinert slings are placed on the woman. Over time, the implant is overgrown with patient tissue. This contributes to the formation of a new muscle frame.	90%
	Muscle tissue in the urogenital area is tightened with sutures, which dissolve after a certain time.	85-90%
	The tissues located around the urethra are attached to the inguinal ligaments using special punctures.	80%

Preventive actions

Prevention of urinary incontinence becomes relevant after 40 years. The instruction is as follows:

Limit your intake of caffeinated beverages. It is advisable to minimize the use of both alcoholic beverages and coffee, strong tea. These drinks have powerful diuretic effects.
Stop using tobacco products. Cigarette smoke irritates the mucous membranes and adversely affects the immune system.
Visit your gynecologist regularly. This will help to timely detect and cure provocative diseases.
Normalize your diet. Refuse foods that contribute to weight gain.
Learn to cope with the effects of stress.

Conclusion

If the problem was discovered in a timely manner, then the condition can be normalized in a short time. Otherwise, the treatment will be very long.

For more information, see the video in this article.