|
| |
Keywords: urine urinary incontinence leaking bedwetting bed wetting enuresis infection
estrogen Premarin Estrace hormone menopause estradiol oestradiol side effects
complications aging disability preventative medicine diagnosis treatment
With approaching menopause and during the years that follow, normal aging and declining
estrogen levels may affect the lining of the urethra (the tube through which urine empties
from the bladder), causing it to become thin and the surrounding muscles to weaken. As a
result, a woman may have involuntary leakage --called incontinence (especially when
sneezing, coughing, laughing, or lifting), more frequent urination, urgency (suddenly
needing to urinate even though the bladder may not be full), nocturia (getting out of bed
to urinate several times during the night), and painful urination. Other common causes of
these problems are urinary tract infections, other medical conditions (such as nerve
disorders), and certain prescription drugs (like diuretics and tranquilizers). Therefore,
a diagnosis must confirm the exact cause --one should not just assume it's old age or
menopause.
Early diagnosis and treatment can often completely cure the problem; if a complete cure
is not possible, at least comfort can usually be improved. Although as many as 40% of
women aged 45 to 64 have urinary incontinence, fewer than half seek help --often because
of embarrassment or the misconception that the condition is an inevitable consequence of
aging and cannot be treated.
 | Causes
 | Urinary tract infections |
 | Lack of Estrogen |
 | Anatomical weakness from childbirth injuries, congenital problems, or previous pelvic
surgery |
 | Bladder Tumors--especially if there is blood in the urine |
 | Irritable or unstable bladder |
 | Medications--fluid pills, tranquilizers and anti depressants, drugs for high blood
pressure, ulcers |
 | Neurological disease--disorders of nerves, the spinal cord or brain which effect bladder
functioning such as strokes, multiple sclerosis, diabetes, or degenerative disk disease of
the spine |
|
 | Assessment A thorough assessment involves a
comprehensive medical history and physical examination-- both general and neurological,
and an examination of the urine for blood and signs of infection. If these studies
are unremarkable, some simple measures make by taken to try to relieve the symptoms such
as treatment of an infection, pelvic floor exercises, changing of medications, or topical
hormones. If things are do not improve with a reasonable period of time, further
assessments of the functioning of the bladder and kidney may be necessary including
looking inside of the bladder with a cystoscope, checking the urine for the presence of
malignant cells, and studies of the function of the bladder through pressure studies
called urodynamics. If specific functional abnormalities are founds, medications may
be used to improve the functioning of the bladder and give better control. If the
problem is an anatomical weakness of the bladder supports (and this is the most common
cause of persistent incontinence, particularly in women age 30-60) than surgery may be
indicated. There are many surgical approaches including vaginal, abdominal, and
laparoscopic approaches.
Dr. Andrew Dott teaches advances hysteroscopic and
laparoscopic surgical techniques, is on the speaker's panels for several American
pharmaceutical companies and is a professional lecturer. Among his lecture topics
are female and male menopause, menopause, herbs and medications, endometriosis, and
contraception. He is available to travel and give seminars on the topics covered in
this website both nationally and internationally.

|
|