Urinary incontinence is the medical term for bladder weakness and is defined as “a condition with any involuntary loss of urine that is a social or hygienic problem”. Urinary incontinence affects around 30 to 60 percent of people aged 50 and over. Our experienced team of specialists in Urology CDMX treats all forms of bladder weakness and would also like
to free our patients from the uncomfortable feeling of insecurity that they often have about whether the people around them might notice something of their incontinence.
The involuntary loss of urine can have many causes. Accordingly, a distinction is made between various forms, such as stress or stress incontinence, urge or urge incontinence, reflex incontinence, overflow incontinence, and extra urethral incontinence.
- Basic examinations
- Survey (incontinence questionnaires)
- Clinical examination
- Micturition protocol
- Template test (pad test)
- Special urological diagnostics
- Ultrasound examination of the urinary bladder and kidneys
- Perineal sonography
- Urodynamic examination (functional test of the bladder and sphincter muscles)
- Cystography (x-ray examination of the urinary bladder)
- Dynamic pelvic floor MRI
Pelvic floor training:
Pelvic floor training is suitable for people of all ages and genders. The aim of the gymnastic exercises is to strengthen the entire muscular system of the pelvic floor and thus to strengthen the bladder sphincter again.
Especially after operations in the small pelvis, in the area of the sphincter muscles, or after childbirth, their locking force can be weakened.
The individual exercises are carried out under detailed professional guidance in cooperation with physiotherapists. Pelvic floor exercises require patience and perseverance, but the effort is worth it. The following measures can usefully complement physiotherapy:
For patients who cannot actively tense their pelvic floor themselves, electrical stimulation can help – both with stress incontinence and with the urge or mixed incontinence.
With electrical stimulation, the sphincter muscle is tensed by electrical current impulses with a frequency of 5 or 10 Hz without any action on the part of the person concerned.
To do this, the electrodes are inserted into the vagina or anus with a probe. The direct influence on the nerves causes a contraction of the pelvic floor muscles and can bring about a normalization of the reflex pattern of the sphincter. With the electro stimulation pelvic floor exercises, the strength of the muscles increases, the muscle tone increases, and the contractility of the pelvic floor is improved.
Electrostimulation using the probe is comparatively simple and can easily be carried out at home. A treatment sequence is around 30 minutes once or twice a day.
With regular use, success rates of almost 90 percent are often achieved after about six months. For permanent improvement, the stimulation can also be continued after the end of the initial treatment.
The electrical stimulation should not be used to treat incontinence in the following cases:
- Urinary tract infections
- Uterus myxomatosis with a tendency to grow
- Urinary retention
- Severe cardiac arrhythmia
- Menstruation, intermenstrual bleeding
- Inflammation (colpitis) in patients with a pacemaker
If a man or woman has little feeling for the pelvic floor, biofeedback devices help. A probe is inserted through the vagina or anus. The person concerned then tenses the pelvic floor and the probe measures the small electrical impulses that arise when the muscles are tensed.
The pulses are converted into an acoustic signal, for example. The device compares the values with the specified target values. If these are reached, the device gives the patient a signal.
This allows patients to see and hear what they cannot feel: whether or not they are properly coordinating the pelvic floor muscles. The advantage of the devices is that those affected receive an optical or acoustic display of his / her training and are thus more easily motivated to exercise.
Magnetic chair Therapy:
The magnetic chair is used for urge incontinence, stress incontinence, and mixed incontinence, but also for incontinence after removal of the prostate. In this pain-free therapy, the patient sits fully dressed on a therapy chair. He does not have to undress and no electrodes are placed on his skin or probes inserted.
There is a magnetic head under the seat of the chair that generates electromagnetic pulses. These stimulate the nerve cells and trigger short pulse-like muscle contractions in the pelvic floor muscles. The urologist adjusts the intensity of the electromagnetic impulses individually to the patient during the treatment.
With this therapy, the urinary bladder sphincter and the pelvic floor muscles are passively trained. The treatment is completely free of side effects and pain.
Depending on the doctor’s prescription, eight to twelve sessions over twenty minutes are sufficient to achieve noticeable results. However, the treatment is not suitable for patients with heart pacemakers or artificial hip joints made of metal.
Vibration training is another gentle method to train the muscles in the pelvic floor and counteract stress incontinence. The patient stands or lies on an electronically controlled vibration plate.
The procedure works on the principle of reflex-induced muscle contraction: During the vibration, the muscle is passively stretched so that the sensors in the muscle tissue are activated and send a signal to the spinal cord. There the signal is switched and sent back to the muscle, causing it to reflexively contract.
Side effects of vibration training are increased blood circulation, improvement of balance, prevention of osteoporosis, and an improvement in the complexion of the skin, for example with cellulite.
Pessaries are well suited for treating incontinence in women. A pessary is a bowl, ring, or cube made of body-friendly, non-allergenic rubber or silicone. It can be used to treat various degrees of vaginal and uterine sagging.
By wearing a pessary, the organs in the pelvis can be supported and the pelvic floor muscles can be strengthened. The pessary is inserted into the vagina with a little lubricant – patients can do this themselves at home.
Depending on the degree of incontinence, the pessaries can be worn all day or only during physical exertion. The pessary does not have to be removed when using the toilet. There is a pull-back thread for removal, as with conventional tampons. Afterward, cleaning with water is sufficient and can also be reused.