How to treat urinary incontinence in an elderly person. Treatment of urinary incontinence in the elderly with medications

Treatment of urinary incontinence in elderly women includes taking a complex of medications with different pharmacological properties, the choice of which depends on the type of disease that caused the pathological condition of the genitourinary system. Physiotherapeutic treatment methods and surgery are also used.

Urinary incontinence in older women is most often associated with age-related changes, when the endocrine glands cease to produce sufficient amounts of estrogen, the tone of the muscle fibers of the pelvic floor decreases, the sphincter of the bladder is in a relatively relaxed state, which entails involuntary leakage of urine from the urethra.

Urinary incontinence - treatment

How to treat urinary incontinence? There are a number of techniques that can reduce the symptoms of the pathology, or completely cure uncontrolled urination. Urinary incontinence in old age can be caused by hormonal imbalance, urinary tract infection, tumor processes, and urolithiasis.

Based on this, a therapy is selected that will be most effective in a particular clinical case.

The following methods of treating urinary incontinence in older women are distinguished:

• physiotherapeutic – consists of performing special exercises and procedures that strengthen and maintain the tone of the muscle fibers of the pelvic floor (indicated for elderly women in whom senile urinary incontinence is caused by a natural weakening of the muscles responsible for the contraction of the bladder sphincter);
• medicinal - consists of a course of medications that eliminate bacterial infection, expand the spasmodic walls of the urinary canals, cleanse the kidneys and other organs of the excretory system from stones, sand and other concretions that disrupt the natural outflow of urine from the body (this method of treatment consists of taking tablets, intramuscular and intravenous injections, vaginal suppositories, steam baths, douching solutions);
• surgical intervention - is used if age-related urinary incontinence is a consequence of a disease or organic damage to the tissues of the kidneys, bladder and excretory canals (in some cases, after a comprehensive examination, women are diagnosed with tumors in the uterus that exert static pressure on the bladder, causing uncontrolled release of urine during coughing, lifting heavy objects, squatting).

Which remedy to choose for urinary incontinence in older people is determined by the attending physician, who initially conducted the examination, established the true cause of the pathology and methods of counteracting the disease.

Drug treatment

The most common type of treatment for urinary incontinence in the elderly. It is especially effective if incontinence is caused by excessive bladder activity or neurogenic diseases, as a result of which the pelvic floor muscles are exposed to a large number of chaotic neural impulses. This type of urinary incontinence in older people is also called urgent.

To cure a person from spontaneous leakage of urine using a medicinal method, it is recommended to use drugs in the following categories:

• antispasmodics - drugs that relax contracted muscles located in close proximity to the bladder and urethra (Drotoverina hydrochloride, Spazmolgon, Spazmol, No-shpa);
• antidepressants - stabilize the neural activity of the centers of the cerebral cortex responsible for the functioning of the organs of the genitourinary system, timely contraction of the muscles involved in the process of excreting urine outside the female body (Sertraline, Escitalopram, Fluoxetine, Citalopram);
• sedatives are drugs whose pharmacological properties are aimed at suppressing excessive hyperactivity of the bladder, when an elderly woman experiences a frequent urge to go to the toilet when the organ is not completely filled, and almost immediately an involuntary leakage of urine occurs (Glycine, Passionflower, Leonurus or Peony tincture, Dormiplant, Persen, Valdispert);
• medicines for urolithiasis - used if senile incontinence is caused by the presence of sand, stones and other concretions in the bladder or excretory canals, disrupting the natural outflow of urine, causing its accumulation in the urethra, inflammation and irritation of the mucous membrane (Cyston, Phytolysin, Nieron, Uralite , Nephrolit, Canephron, Rowatinex, Olimethine);
• antibacterial and anti-inflammatory drugs - used for the treatment of senile incontinence, if the nature of its origin is associated with the penetration of pathogenic microorganisms into the woman’s genitourinary system (the medicine of this pharmacological group is selected individually depending on the strain of the bacterial infection that the diagnosis showed);
• replacement therapy with injectable insulin, when urinary incontinence has developed as a result of the presence of a concomitant disease in the form of diabetes (the dosage of insulin is determined based on the level of glucose in the blood of the sick woman);
• chemical preparations, if urinary incontinence is associated with the presence of an oncological process in the tissues of the organs of the reproductive or genitourinary system (administered intravenously during a previously developed course of treatment, and is used only for malignant neoplasms).

Read also on the topic

Why do men leak urine after urinating?

To relieve urinary incontinence in older women, one or more drug therapies can be used. Tablets, injections, and intravaginal suppositories are used. It is important to remember that self-treatment is prohibited, since in order to obtain effective therapy, a comprehensive diagnosis of the whole organism must first be carried out, the cause of the pathology of the excretory system must be established, and only after that treatment for uncontrolled urine leakage is prescribed.

Physiotherapy for urinary incontinence

This method of treating the disease is based on performing exercises and procedures that strengthen the muscles of the sphincter of the bladder and the pelvic floor as a whole. Some of them can be performed by an elderly woman independently, while at home, and such as warming up and stimulation of nerve endings using electromagnetic pulses are carried out in the manipulation rooms of a clinic.

To get rid of an uncomplicated form of urinary incontinence, it is recommended to perform the following exercises and physiotherapeutic procedures:

• squats with your own weight (it is enough to do 10 repetitions in the morning and evening to maintain the tone of the muscle fibers responsible for excreting urine);
• deliberately contract and relax the anal sphincter, along with which the muscles located around the bladder and urethra are compressed and trained;
• warming the pelvic area in warm water, it is recommended to first add a small amount of manganese, chamomile decoction, and chlorhexidine solution with a 3% concentration;
• therapeutic massage of the lower abdomen with impact on the walls of the bladder to ensure an influx of additional blood volume and natural relaxation of spasming muscles;
• electromagnetic stimulation of the muscle fibers of the pelvic floor in the presence of signs of polyneuropathy, when enuresis appears due to dysfunction of nerve endings, poor conductivity of neural impulses (performed in the inpatient department of a physiotherapy room, where electrophoresis and devices for warming the body using electrical energy are used).

The positive therapeutic effect of daily physiotherapeutic procedures and exercises occurs after 1-3 months. It is best that physical therapy and stimulation of the pelvic floor muscles with electrophoresis be performed in conjunction with traditional drug therapy.

Surgery

What to do if medications and physical exercises to train the pelvic floor muscles do not bring the desired results, and urinary incontinence continues to bother an elderly woman? A radical method of therapy is the use of surgery.

It can be applied in the following cases:

• removal of a malignant or benign tumor in the tissues of the genitourinary system, if their presence has disrupted the natural process of urine outflow, its retention in the cavity of the urethra and further leakage during physical movements;
• plastic or surgical tightening of the muscle fibers of the sphincter of the bladder, as well as those that ensure the removal of urine from the woman’s body;
• bougienage of the urethra, carried out in the operating room under local or general anesthesia (performed to restore the passage of urine if the structure of the urethra has been damaged as a result of inflammatory processes or mechanical damage);
• slinging or surgery, the principle of which is to suture the neck of the bladder so that it is in a more elevated state and minimizes the chances of spontaneous leakage of urine due to muscle weakness (polymer materials are used, they do not enter into a biochemical reaction with the woman’s body, eliminating the possibility rejection of threads as foreign objects, rehabilitation time is reduced);
• laparoscopic penetration into the urethral cavity and fixation of periurethral tissues to the inguinal folds (considered the most recommended method of surgical treatment, after which the positive effect remains for a long time);
• surgical removal of stones if they are stuck in the bladder or excretory canals and interfere with the natural process of urination (both laparoscopic penetration through the urethra, so as not to injure the epithelial surface of the abdominal cavity and the walls of internal organs, and traditional strip dissection of the body can be used).

In older people, urological pathologies are among the most common disorders and are accompanied by a number of characteristic features. Moreover, such a phenomenon causes a lot of trouble for the person suffering from it, both from a personal, medical, and social point of view. According to statistics, urinary incontinence occurs in approximately 5-15% of elderly people living at home, and in approximately every fifth patient belonging to the older age group hospitalized in medical institutions. But among residents of nursing homes, the prevalence of the disease is already approximately 70%. Moreover, urinary incontinence occurs twice as often in older women as in men.

Urinary incontinence in older people causes a significant deterioration in their quality of life and certain life and situational difficulties. Quite often, this phenomenon becomes a prerequisite for avoiding society, developing an inferiority complex and feelings of guilt in a person, and also provokes depressive states.

Types of urinary incontinence in older people

In medical practice, there are several types of urinary incontinence in older people. Among them:

• Stress incontinence is the uncontrollable leakage of urine, which is provoked by physical exertion, occurs as a result of lifting heavy objects, while laughing or coughing. Its main cause is age-related changes in the body and, in particular, increased weakness of the pelvic muscles;
• Urge incontinence is a condition associated with an irresistible urge to urinate, and which is a consequence of exposure to external irritants. For example, the activity of the bladder reflexively increases when washing dishes, if water is flowing nearby in a fountain, as well as in the cold;
• Transient incontinence is a phenomenon that occurs against the background of infectious and inflammatory diseases affecting the genitourinary system (for example, it can result from cystitis or inflammation of the vagina);
• Overflow incontinence is a fairly rare occurrence. Moreover, this type of urinary incontinence is much more common in older men than in women. It is caused by various types of prostate diseases, among which a special place is occupied by prostate hyperplasia, oncological lesions, and urethral stricture (narrowing of the urethra). Treatment of urinary incontinence in the elderly in this case is most often carried out using surgical methods;
• Mixed type is a condition characterized by the presence of several forms of incontinence in a person at the same time. As a rule, it requires an integrated approach to treatment.

Causes of urinary incontinence in older people

Urinary incontinence in representatives of the older age group in most cases is a consequence of certain physiological changes that accompany the aging process of the body (for example, with age, all people experience a decrease in bladder volume). In addition, problems with urinary control can occur for a number of other reasons. Moreover, quite often urinary incontinence in elderly people is temporary, and after eliminating the cause that caused the failure of the regulatory mechanism, the ability to restrain the urge to urinate is completely restored.

Factors that provoke urinary incontinence include:

• Disorders of integrative activity of the brain (or, in other words, confusion, when the patient ceases to realize that he wants to go to the toilet);
• Infectious processes affecting the urinary tract;
• Violation of the integrity of the mucous membranes in the urinary and genital tracts (usually observed in postmenopausal women);
• Taking certain medications;
• The process of swelling subsiding;
• Increased urine production (polyuria), which is accompanied by the fact that a person feels the urge to urinate and is fully aware of the need to go to the toilet, but simply does not have time to go there;
• Restriction of a person’s mobility (in such cases, to avoid urinary incontinence in older people, a urinal is used);
• A complication of constipation in the form of fecal blockage (usually typical for bedridden and sedentary patients, and is also observed in people suffering from mental disorders).

Features of urinary incontinence in older women

Urinary incontinence occurs in approximately 2/3 of older women. At the same time, 30-40% of cases are due to stress incontinence, 15-20% are due to urgent incontinence, and another 45% are mixed forms of pathology. Other types of urinary incontinence in older women average from 2 to 15%.

The main reasons why such an unpleasant phenomenon occurs in the fair half of humanity include:

• Changes in hormonal balance, which is accompanied by a decrease in the amount of female sex hormones, as well as atrophic changes that contribute to a decrease in overall muscle tone in the pelvic area;
• Increased tone of the bladder muscles due to bladder hypersensitivity, Parkinson's disease, strokes, stress or damage to the nervous system;
• Congenital malformations and inferiority of pelvic floor tissues;
• Surgical operations performed on the female genital organs;
• Inflammatory diseases of the female reproductive system.

Features of urinary incontinence in older men

This is one of the serious causes of most complexes and mental disorders. As a rule, urinary incontinence in older men is a consequence of weakening of the sphincters that retain urine, as well as fatty degeneration of the walls of the bladder. Another prerequisite for the development of pathology is the fact that as the body ages, the nerve impulses that force a person to wake up and empty the bladder are significantly weakened. In some cases, the cause of purely male incontinence is prostate adenoma. It contributes to dysfunction of urination, which provokes overflow of the bladder and subsequent involuntary release of urine at the most inopportune moment.

During the daytime, urinary incontinence can be caused by increased muscle tension, sharp and irritating sounds, coughing, etc. Diseases such as multiple sclerosis and Parkinson's disease aggravate the situation.

Treatment of urinary incontinence in older people

The treatment regimen depends on what causes the disease. Treatment of urinary incontinence in older people is based on:

• Use of medications;
• Support of the patient by family and friends;
• Reducing the amount of fluid consumed before bedtime;
• Performing procedures that are aimed at increasing the reaction of the sphincters that retain urine (for example, cold rubdowns in the morning);
• Maintaining muscle tone (patients are recommended to walk and do as much physical activity as possible).

Incontinence, or urinary incontinence in elderly patients, occupies an important place in urological pathology. , psychologists and neurologists are constantly working to find the most effective cure for this disease.

To eliminate the problem, which is diagnosed as urinary incontinence in the elderly, serious and comprehensive treatment will be required.

The following types of urinary incontinence in old age are known:

1. Stress - uncontrollable leakage of urine provoked by physical actions. It is characterized by the absence of a natural urge to defecate.
2. Urgent - involuntary leakage associated with an irresistible urge to urinate.
3. Mixed - the presence of several types of incontinence in one person. If such urinary incontinence occurs in the elderly, complex treatment is required.
4. Overflow incontinence is a rare form of incontinence that typically occurs among older men with prostate disease. With this type of urinary incontinence in the elderly, surgical treatment is used more often than with the urgent type.

Causes of urinary incontinence in old age

Choosing the right methods for treating urinary incontinence in old age is possible only after an accurate diagnosis of the cause of the disease. The main causes of urinary incontinence in old age are:

1. Diseases or injuries of the spine, spinal cord;
2. Neurogenic bladder;
3. Tumors and severe prolonged inflammation of the excretory system

Urinary incontinence in old age in women, due to disruption of the structure of the female reproductive organs:

• Prolapse of the uterus, severe inflammation of the female genital organs;
• Difficult childbirth, perineal injuries;
• Gynecological interventions;
• Endourethral surgeries;
• Hard physical labor.

To eliminate many causes of urinary incontinence in the elderly, treatment with traditional medicinal methods is often quite sufficient.

Treatment methods for urinary incontinence in the elderly

There are three main methods of treating urinary incontinence in the elderly:

• physiotherapeutic,
• medicinal
• and surgical.

The physiotherapeutic method consists of strengthening the muscles of the pelvis and bladder using special exercises and/or devices.

Drug therapy is usually the use of so-called M-anticholinergics, less often tricyclic antidepressants.
Surgical treatment is more often used for patients with overflow and stress type incontinence, and less often with urgent incontinence.

In patients with stress urinary incontinence, the so-called. TVT operations in which a synthetic tape is implanted under the middle third of the urethra.

Patients with urge urinary incontinence may benefit from injections of botulinum toxin into the bladder.

Treatment of urinary incontinence in the elderly at URO-PRO

It is possible to select the correct treatment for urinary incontinence in the elderly at the international medical company URO-PRO, which offers a wide range of disease treatment services.

"URO-PRO" guarantees a successful treatment result. Thanks to internships in foreign branches, doctors improve their professionalism, expand their individual practice, master advanced techniques, and work with advanced equipment for diagnosis and treatment.

The URO-PRO medical center uses innovative methods and methods of treatment, which are combined with an individual, almost exclusive approach to each individual patient.

It is very important to consult a specialist in a timely manner for a correct diagnosis and selection of effective treatment. Patients from different cities - Krasnodar, Sochi, Rostov-on-Don, Yekaterinburg - come to the URO-PRO center and invariably receive high-quality medical care. Confidentiality is guaranteed.

Treatment of urinary incontinence in elderly women includes taking a complex of medications with different pharmacological properties, the choice of which depends on the type of disease that caused the pathological condition of the genitourinary system. Physiotherapeutic treatment methods and surgery are also used.

Urinary incontinence in older women is most often associated with age-related changes, when the endocrine glands cease to produce sufficient amounts of estrogen, the tone of the muscle fibers of the pelvic floor decreases, the sphincter of the bladder is in a relatively relaxed state, which entails involuntary leakage of urine from the urethra.

Urinary incontinence - treatment

How to treat urinary incontinence? There are a number of techniques that can reduce the symptoms of the pathology, or completely cure uncontrolled urination. Urinary incontinence in old age can be caused by hormonal imbalance, urinary tract infection, tumor processes, and urolithiasis.

Based on this, a therapy is selected that will be most effective in a particular clinical case.

The following methods of treating urinary incontinence in older women are distinguished:

• physiotherapeutic – consists of performing special exercises and procedures that strengthen and maintain the tone of the muscle fibers of the pelvic floor (indicated for elderly women in whom senile urinary incontinence is caused by a natural weakening of the muscles responsible for the contraction of the bladder sphincter);
• medicinal - consists of a course of medications that eliminate bacterial infection, expand the spasmodic walls of the urinary canals, cleanse the kidneys and other organs of the excretory system from stones, sand and other concretions that disrupt the natural outflow of urine from the body (this method of treatment consists of taking tablets, intramuscular and intravenous injections, vaginal suppositories, steam baths, douching solutions);
• surgical intervention - is used if age-related urinary incontinence is a consequence of a disease or organic damage to the tissues of the kidneys, bladder and excretory canals (in some cases, after a comprehensive examination, women are diagnosed with tumors in the uterus that exert static pressure on the bladder, causing uncontrolled release of urine during coughing, lifting heavy objects, squatting).

Which remedy to choose for urinary incontinence in older people is determined by the attending physician, who initially conducted the examination, established the true cause of the pathology and methods of counteracting the disease.

Drug treatment

The most common type of treatment for urinary incontinence in the elderly. It is especially effective if incontinence is caused by excessive bladder activity or neurogenic diseases, as a result of which the pelvic floor muscles are exposed to a large number of chaotic neural impulses. This type of urinary incontinence in older people is also called urgent.

To cure a person from spontaneous leakage of urine using a medicinal method, it is recommended to use drugs in the following categories:

• antispasmodics - drugs that relax contracted muscles located in close proximity to the bladder and urethra (Drotoverina hydrochloride, Spazmolgon, Spazmol, No-shpa);
• antidepressants - stabilize the neural activity of the centers of the cerebral cortex responsible for the functioning of the organs of the genitourinary system, timely contraction of the muscles involved in the process of excreting urine outside the female body (Sertraline, Escitalopram, Fluoxetine, Citalopram);
• sedatives are drugs whose pharmacological properties are aimed at suppressing excessive hyperactivity of the bladder, when an elderly woman experiences a frequent urge to go to the toilet when the organ is not completely filled, and almost immediately an involuntary leakage of urine occurs (Glycine, Passionflower, Leonurus or Peony tincture, Dormiplant, Persen, Valdispert);
• medicines for urolithiasis - used if senile incontinence is caused by the presence of sand, stones and other concretions in the bladder or excretory canals, disrupting the natural outflow of urine, causing its accumulation in the urethra, inflammation and irritation of the mucous membrane (Cyston, Phytolysin, Nieron, Uralite , Nephrolit, Canephron, Rowatinex, Olimethine);
• antibacterial and anti-inflammatory drugs - used for the treatment of senile incontinence, if the nature of its origin is associated with the penetration of pathogenic microorganisms into the woman’s genitourinary system (the medicine of this pharmacological group is selected individually depending on the strain of the bacterial infection that the diagnosis showed);
• replacement therapy with injectable insulin, when urinary incontinence has developed as a result of the presence of a concomitant disease in the form of diabetes (the dosage of insulin is determined based on the level of glucose in the blood of the sick woman);
• chemical preparations, if urinary incontinence is associated with the presence of an oncological process in the tissues of the organs of the reproductive or genitourinary system (administered intravenously during a previously developed course of treatment, and is used only for malignant neoplasms).

Read also on the topic

Why do men leak urine after urinating?

To relieve urinary incontinence in older women, one or more drug therapies can be used. Tablets, injections, and intravaginal suppositories are used. It is important to remember that self-treatment is prohibited, since in order to obtain effective therapy, a comprehensive diagnosis of the whole organism must first be carried out, the cause of the pathology of the excretory system must be established, and only after that treatment for uncontrolled urine leakage is prescribed.

Physiotherapy for urinary incontinence

This method of treating the disease is based on performing exercises and procedures that strengthen the muscles of the sphincter of the bladder and the pelvic floor as a whole. Some of them can be performed by an elderly woman independently, while at home, and such as warming up and stimulation of nerve endings using electromagnetic pulses are carried out in the manipulation rooms of a clinic.

To get rid of an uncomplicated form of urinary incontinence, it is recommended to perform the following exercises and physiotherapeutic procedures:

• squats with your own weight (it is enough to do 10 repetitions in the morning and evening to maintain the tone of the muscle fibers responsible for excreting urine);
• deliberately contract and relax the anal sphincter, along with which the muscles located around the bladder and urethra are compressed and trained;
• warming the pelvic area in warm water, it is recommended to first add a small amount of manganese, chamomile decoction, and chlorhexidine solution with a 3% concentration;
• therapeutic massage of the lower abdomen with impact on the walls of the bladder to ensure an influx of additional blood volume and natural relaxation of spasming muscles;
• electromagnetic stimulation of the muscle fibers of the pelvic floor in the presence of signs of polyneuropathy, when enuresis appears due to dysfunction of nerve endings, poor conductivity of neural impulses (performed in the inpatient department of a physiotherapy room, where electrophoresis and devices for warming the body using electrical energy are used).

The positive therapeutic effect of daily physiotherapeutic procedures and exercises occurs after 1-3 months. It is best that physical therapy and stimulation of the pelvic floor muscles with electrophoresis be performed in conjunction with traditional drug therapy.

Surgery

What to do if medications and physical exercises to train the pelvic floor muscles do not bring the desired results, and urinary incontinence continues to bother an elderly woman? A radical method of therapy is the use of surgery.

It can be applied in the following cases:

• removal of a malignant or benign tumor in the tissues of the genitourinary system, if their presence has disrupted the natural process of urine outflow, its retention in the cavity of the urethra and further leakage during physical movements;
• plastic or surgical tightening of the muscle fibers of the sphincter of the bladder, as well as those that ensure the removal of urine from the woman’s body;
• bougienage of the urethra, carried out in the operating room under local or general anesthesia (performed to restore the passage of urine if the structure of the urethra has been damaged as a result of inflammatory processes or mechanical damage);
• slinging or surgery, the principle of which is to suture the neck of the bladder so that it is in a more elevated state and minimizes the chances of spontaneous leakage of urine due to muscle weakness (polymer materials are used, they do not enter into a biochemical reaction with the woman’s body, eliminating the possibility rejection of threads as foreign objects, rehabilitation time is reduced);
• laparoscopic penetration into the urethral cavity and fixation of periurethral tissues to the inguinal folds (considered the most recommended method of surgical treatment, after which the positive effect remains for a long time);
• surgical removal of stones if they are stuck in the bladder or excretory canals and interfere with the natural process of urination (both laparoscopic penetration through the urethra, so as not to injure the epithelial surface of the abdominal cavity and the walls of internal organs, and traditional strip dissection of the body can be used).