A useful agent in the treatment of bladder incontinence is:
A- Nalmefene
B- olterodine
C- Tolcapone
D- Valrubicin
E- None of the above.
A- Nalmefene
B- olterodine
C- Tolcapone
D- Valrubicin
E- None of the above.
What are the treatments for urinary incontinence?
The treatments for urinary incontinence implement rehabilitation techniques for perineum and bladder muscles, but also behavioral techniques to better manage your desires to urinate. Sometimes the doctor prescribes drugs in local application, orally or in injections. In women, if the perineum muscles are too relaxed, a polymer strip can be placed through the vagina and the skin of the abdomen during surgery under local or epidural anesthesia.
The treatments for incontinence of effort linked to menopause:
Perineosphincter rehabilitation:
Perineosphincter rehabilitation (perineum and bladder muscles) is recommended in incontinence of effort and mixed. It is sometimes useful in incontinence by imperiousness after using so -called "anticholinergic" drugs (see treatments for incontinence by imperiality). The use of several techniques (manual, biofeedback, electrostimulation) seems more effective than the practice of only one. The benefit can only be appreciated after 15 to 20 sessions.
In the event of urinary effort incontinence, self -relief work should be practiced by the patient between rehabilitation sessions.
Local estrogen applications:
In the case of an incontinence of effort linked to menopause, it is possible to set up treatment to correct estrogen deficits. Applied by local route, estrogens play a role in improving pressure in the urethra, the strength of the pelvis muscles and the relaxation of the bladder during the filling phase.
Compared to the oral administration, the local route has the advantage of being as effective without causing undesirable effects. Prescribed for two months, this treatment must be associated with rehabilitation management.
Sub-command strips:
If the perineum muscles are too relaxed, a polymer strip can be placed through the vagina and the skin of the abdomen during a half-hour surgery under local or epidural anesthesia (TVT method). This intervention, which must be carried out by a surgeon accustomed to this technique, makes it possible to support the urethra canal and to facilitate the retention of urine.
Dextramonomer/hyaluronic acid implant injections:
These injections are carried out under local anesthesia. Like strips, these semi-resorbable implants help support the urethra canal and facilitate urine retention. The risk of transitional urine retention requires surveillance a few hours after injection.
Treatments of incontinence by imperiality:
Behavioral therapies:
Behavioral therapies aim to teach people who suffer from incontinence by imperiality to better control their desires to urinate. They are based on a programming of mictions (urinating) throughout the day and on learning how to react in case of pressing desire. These therapies promote awareness of the deadlines and frequencies of urination to combat certain anxious or phobic behaviors aggravating the consequences of incontinence.
So -called “anticholinergic” drugs:
These drugs contain a substance that reduces the sensitivity and hyperactivity of the bladder. They can be prescribed immediately or after the failure of behavioral treatment or rehabilitation. No anticholinergic drug seems to be superior to behavioral therapy, but the combination of behavioral/anticholinergic therapy can be beneficial.
The effects of different anticholinergic drugs on symptoms are similar and modest. Maximum efficiency is reached after 5 to 8 weeks of treatment. It is therefore recommended not to interrupt the treatment earlier, if it is well tolerated.
Their side effects are more frequent in the elderly: oral dryness, constipation, redness of the face, urine retention, vision disorders, headaches, confusion, anxiety, etc.
In some cases of incontinence by imperiality, an non -anticholinergic antispasmodic medication, flavoxate (URISPAS), can be prescribed.
