Urinary incontinence when coughing: a problem that should not be kept silent

Many women face a problem such as urinary incontinence (or incontinence), which occurs when coughing, trying to sneeze or even laugh. After pouring out a portion of urine, a representative of the fair sex feels awkward, suffers from an annoying feeling of humidity, an unpleasant odor and an irresistible desire to wash herself. Such an unpleasant phenomenon can occur anywhere - at work, on public transport, just on the street or at home. A woman is forced to use sanitary pads and change them frequently, is embarrassed by herself, is afraid of sneezing or coughing, and tends to be in public places less often.

Why does this unpleasant and delicate symptom occur? How can you fight it? You will get answers to these burning questions in this article. They will help you start moving in the right direction, and you will get rid of the annoying feelings of uncleanliness.

Many believe that the symptom discussed in this article is a purely age-related problem. However, this misconception is incorrect, since a similar problem can arise even among young representatives of the fair sex.

When visiting a doctor, you usually hear the following complaints from women suffering from urinary incontinence:

• Not a single pad can help, and I am very ashamed of the smell;
• I'm afraid to laugh, cough or sneeze;
• I change 10-12 pads a day, but I can’t get rid of the smell and the unpleasant feeling of moisture;
• I constantly feel the urge to wash myself and change my underwear.

Some women attribute these standard complaints to difficult childbirth, age-related changes, or obesity. Unfortunately, a number of representatives of the fair sex 40-50 years old do not even rush to see a doctor, but console themselves with the thought that the same symptoms were observed in their mother, grandmother or aunt. However, the occurrence of urinary incontinence when coughing or sneezing at any age should always be a reason to visit a doctor. There are two reasons for such consultation:

• in many clinical cases, this problem can be eliminated with conservative therapy or surgery;
• Urinary incontinence is often a sign of diseases that require mandatory treatment.

The presence of a problem of incontinence when coughing, laughing or sneezing often becomes noticeable to others: such women have a tense and gloomy look, they can burst into tears at any moment, they are afraid to laugh, cough, sneeze or get too close to a person. Such representatives of the fair sex have to constantly think about having a toilet within close proximity; they deliberately limit themselves from attending various events, traveling and other pleasures of life.

Causes

In most cases, urinary incontinence occurs in women over 40 years of age.
Practitioners note that urinary incontinence when coughing or sneezing is more often observed in pregnant women, in women after difficult childbirth, or in the fair sex after 40 years. However, in some cases, this symptom occurs even in young women.

The causes of incontinence in women when laughing, coughing and sneezing can be as follows:

• history of difficult childbirth;
• frequent pregnancies and childbirths;
• pelvic organ injuries;
• previous operations complicated by damage to the pelvic organs;
• undergoing radiation therapy;
• progressive decrease in estrogen levels;
• hormonal imbalance during menopause;
• weakness or overstretching of the bladder muscles;
• uterine prolapse;
• prolapse of the vaginal walls;
• shortened urethra;
• neoplasms of the bladder or spinal cord;
• obesity;
• some pathologies of the spinal column;
• respiratory diseases;
• heavy physical work associated with lifting weights and leading to increased intra-abdominal pressure;
• taking diuretics.

Disease research methods

Doctors consider urinary incontinence when coughing as a separate disease. To make a correct diagnosis, the doctor suggests the following research methods.

Physiological examination of the patient.

• Familiarization with complaints.
• Study of a voiding diary.
• Cough test, Bonnie test - creating conditions for involuntary urination when performing any physical effort.

Laboratory research.

• Clinical analysis of blood and urine.
• Culture of cough secretions to determine the type of pathogenic microflora.

Instrumental methods.

• Cystoscopy of the bladder is performed to identify abnormalities of its internal structure and foci of infection. The procedure is done using a special device - a cystoscope, which is inserted into the urethra.
• Ultrasound examination of the genitourinary system confirms the presence or absence of the disease.
• X-ray examination of the urinary tract (cystography) shows how the urinary system functions.
• Uroflowmetry - allows you to measure the speed of urine flow during urination.
• Urodynamics of the bladder – evaluates structural changes in the organs of the genitourinary system.

Severity of pathology

Depending on the volume of urine flowing out when coughing, laughing or sneezing, there are 3 degrees of severity of this deviation from the norm:

• mild - with intense exercise, causing an increase in intra-abdominal pressure, a few drops of urine are released;
• medium - urine is not retained in a larger volume even with minor loads;
• severe - urine is not retained even at rest (when getting out of bed or a chair, during sexual intercourse, leisurely walking, or even while sleeping).

Sometimes, if urinary incontinence is caused by urological or gynecological diseases, urine discharge may contain blood.

Diagnostics

The first stage of any diagnosis is the collection of a detailed medical history. The assumptions are confirmed if there are accompanying provoking factors:

• The woman's age is from 35 to 55 years.
• The woman had given birth several times before.
• There are precipitating diseases - diabetes, neurological diseases, etc.

After collecting an anamnesis, it is mandatory to examine the woman in a gynecological chair, during which the doctor assesses the condition of the woman’s genital organs. He also studies the condition of the mucous membrane, and also performs a Valsalva maneuver, i.e., assesses the mobility of the bladder neck.

Next, the patient is required to submit a culture for microflora, as well as a routine urine test. In addition to these tests, the patient must record the total number of times she urinates for two days, as well as how much urine she produces at one time.

An additional study is carried out - ultrasonography. Using this method allows you to achieve the following results:

1. Assess the condition of the bladder, as well as the degree of its displacement.
2. Study of the urethra - its diameter, length.
3. Assessing the condition of the mucosa, as well as obtaining information about the urethra.

The patient is also referred to undergo a comprehensive urodynamic study, which involves the following techniques:

1. Cystometry . This study evaluates the relationship between pressure and volume of fluids in the bladder.
2. Uroflowmetry . This study allows you to estimate the volume of urine excreted over a certain time.
3. Profilometry . During this event, the condition of the urethra is assessed.

This entire set of studies can be supplemented by examinations by a psychologist or endocrinologist, depending on the specific clinical picture.

What rules of personal hygiene should be observed for urinary incontinence?

In case of incontinence, the problem can be alleviated by special urological pads, which can not only quickly absorb and retain fluid, but also deactivate the unpleasant odor of urine. Nowadays you can find a wide range of such hygiene products on pharmacy shelves and in online stores. When choosing, you should remember that the urological pad must meet the following requirements:

• quickly and efficiently absorb liquid and absorb odor;
• keep dry;
• fit according to anatomical parameters;
• ensure bacterial safety.

Remember! The use of urinary pads is only part of the hygiene measures for urinary incontinence. You cannot put off visiting a doctor, as only a specialist will be able to determine the cause of incontinence and draw up the most effective treatment plan.

Folk remedies

Afraid to see a doctor because of urinary incontinence during coughing, women, and even men, try to treat themselves, using traditional medicine. It is excellent in treating the disorder of uncontrolled urination.

Note!

It is good to use “grandmother’s” recipes together with non-drug therapy.

How to use

The main thing is to follow the doctor’s advice, do special exercises and drink healing herbs until the symptoms disappear completely. All of the decoctions listed below must be taken daily. After preparation, the resulting “potion” must be strained. Drink 3 times a day after meals in equal portions. To add flavor, you can add a spoonful of honey or sugar.

The course of herbal therapy is carried out for a month, after which a two-week break is taken. Then the course is repeated. As a rule, treatment allows you to get rid of incontinence and even a slight leakage of urine during coughing, and the patient’s complete recovery.

Homemade recipes include the following:

• Dill seed decoction. 1 tbsp. l. pour dill seeds with a glass of boiling water and take as described above;
• Decoction of corn silk. 1/3 tbsp. l. stigmas in 200 ml of boiling water, let it brew. This recipe is used for severe cough;
• An excellent solution to the problem of urinary incontinence is a collection of yarrow and St. John's wort in equal proportions. 1 tsp. herbal mixture per 250 ml of boiling water;
• A decoction of St. John's wort and lingonberry leaves helps effectively. Take 1.5 tbsp. l. pour a glass of boiling water over each component;
• A herbal mixture of nettle, marshmallow root and yarrow in a ratio of 50/100/50 is poured into 400 ml of boiling water. This remedy helps fight both cough and the causes of urinary incontinence in women when coughing;

How to get rid of urinary incontinence

This question is asked by every woman who has had the problem discussed in this article. Getting rid of such a delicate and undesirable situation is possible in cases where the root cause of urinary incontinence has been identified and eliminated. To do this, a woman should consult a doctor, who will carefully examine the complaints and history of illness and life, and conduct the necessary additional studies:

• cystoscopy;
• complex urodynamic study;
• Ultrasound;
• MRI;
• CT;
• radiography;
• blood tests for hormones, etc.

All experts are unanimous in the opinion that treatment of incontinence during coughing, laughing, sneezing or other stress should begin as early as possible. A woman should not be embarrassed by this complaint when talking with a doctor - only in this way can she get rid of the existing and life-poisoning problem.

The success of treatment for urinary incontinence depends primarily on a qualified determination of the cause of this unpleasant symptom. The future action plan could be as follows:

• conservative therapy;
• surgery.

According to the observations of doctors, in approximately 50% of cases, incontinence during sneezing, coughing and other stress can be cured without surgery. The integrated use of medications and physiotherapeutic techniques can solve this problem.

The goals of non-drug therapy for urinary incontinence are aimed at strengthening the pelvic floor muscles and bladder walls. In addition, the doctor and patient create a urination plan aimed at increasing the intervals between urinations (they should gradually expand). Why is such a plan created?

With the existing problem, a woman develops a certain stereotype of behavior in relation to urination: she visits the toilet as if “just in case, to prevent embarrassment” and, for fear of embarrassment, does it too often (even with the slightest hint of the urge to urinate). When carrying out the intended plan, the patient should learn to restrain the urge. Every week, the intervals between urinations should be increased by 30 minutes and the result should be increased to 3-3.5 hours. Such events help a woman change her attitude towards the existing stereotype and move away from it. Typically, this urination plan is supported by drug therapy, which is prescribed for 3 months, just like a bladder training program.

An important part of treating urinary incontinence is exercise to train the pelvic floor muscles. It is this technique that allows many women to get rid of an unpleasant symptom and serves as an excellent preventative measure for urinary incontinence. To achieve the goal, the patient may be recommended a program of exercises developed by Dr. Arnold Kegel, and a list of other exercise therapy exercises indicated when a similar problem occurs.

In this article, let's look at the popular Kegel technique:

1. Empty your bladder before starting your workout.
2. The exercises can be performed in the following positions: lying on your back with your legs slightly apart and bent at the knees, lying on your stomach with your legs slightly apart, or lying on your stomach with your knee bent.
3. Squeeze your pelvic floor muscles, pulling them up. Hold for 10 seconds.
4. Completely relax your muscles for 10 seconds.
5. Repeat the steps 10 times for 5 minutes. Do the exercises 3 times a day.
6. Do not make the following mistakes: hold your breath (it should be deep and free), pull in your navel (only the pelvic floor muscles should tense), push the pelvic floor muscles down (they should only go up).

Such simple but effective workouts can not only strengthen the pelvic floor muscles. They relieve a woman of many gynecological problems, improve the quality of intimate life, and relieve drowsiness and apathy.

In addition to physical training, patients with incontinence are prescribed physiotherapeutic procedures:

• electromagnetic pulses;
• microcurrents;
• warming up, etc.

These activities also help strengthen the muscles of the bladder and pelvic floor, make the ligaments more elastic and improve blood circulation in the pelvis.

Drug therapy for urinary incontinence has proven itself and is actively used for various types of this delicate problem.

• Women are usually prescribed antidepressants and antispasmodics.
• In patients with signs of menopause, part of the treatment may be the use of vaginal creams and suppositories containing estrogens (Ovestin).
• One of the well-proven drugs is a drug such as Driptan. This medicine has a relaxing effect on the walls of the bladder and inhibits the flow of impulses from the nervous system. Thanks to this complex effect, Driptan relaxes the walls of the bladder and thereby increases its volume. As a result, the woman’s unreasonable urge to urinate disappears, and she visits the toilet less often. Patients can be convinced of the effectiveness of the drug about a month after starting to take it. The dosage and duration of taking Driptan is determined by the doctor individually.

In a number of clinical cases, conservative therapy for incontinence during coughing, laughing and sneezing turns out to be ineffective and surgical treatment is recommended for the woman to eliminate the existing problem. Today, surgeons have about 250 techniques to eliminate urinary incontinence. Many of them are held in Russia. In some clinical cases, these may be minimally invasive operations (for example, the application of a loop made of synthetic material). After such low-traumatic interventions, the patient can be discharged from the hospital the very next day.

Treatment methods

To identify the reason why urine is released during coughing or during normal physical activity, zаkashlyal.ru advises consulting a urologist. After passing all the necessary tests and undergoing the prescribed examination, the patient will be prescribed individual therapy. Medicine offers treatment for urinary incontinence in several ways:

• Non-medicinal;
• Medication;
• By surgical method.

Non-drug

This therapy includes a special set of exercises that promotes training and strengthens the muscle tone of the vagina. This method is effective and is used for various forms of urinary incontinence, regardless of whether it occurs with coughing or not.

Medication

With this therapy, medications are prescribed whose action is aimed at reducing the activity of urine output. The required dosage of medications is selected by the doctor individually, after a complete examination of the patient. A medical approach is prescribed by a specialist for the treatment of all types of urinary incontinence. A good result is obtained by combining this method with a set of special exercises.

Surgical

This method is used when urinary incontinence cannot be cured with drug and non-drug therapy. Vaginal plastic surgery is performed, creating a special synthetic loop for the urethra. With the help of surgery, it is possible to completely cure the disease.