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 OTHER NAMES
- Involuntary losses of urine
DEFINITION
When an urinal incontinence exists small urine escapes take place on having realized any abdominal movement, for example on having coughed, to sneeze, to laugh, to jump, to load weight or to do exercise.
For it these activities turn into quite difficult and problematic tasks for the affected persons.
The involuntary losses of urine can affect almost 40 % of the women, in his majority of more than 45 years, but it happens in more young people also.
CAUSES
The most habitual cause is the weakness of the pelvic soil that is the set of muscles and sinews that close the abdominal cavity for his part low simultaneously that hold and support in his normal position the bladder, the womb and the rectum.
When for some cause these muscles weaken (surgery sits-up, childbearings, etc...), the organs of this area turn out to be affected and for it one of the most frequent problems is the urinal effort incontinence.
The pelvic muscles usually usually, even do not exercise in sportsmen, then it is an area that easily enters a weakness with the age. In a few persons they weaken more that in others, between the causes there can be the pregnancies and childbearings, the surgeries of the area, the age, the menopause, there is a hereditary tendency, the obesity or the chronic constipation.
But of between all of them the pregnancy and childbearing are the most habitual causers of this problem, especially for the dilation that takes place in this muscular area weaker than others.
The women after the childbearing tend to do exercise, especially sits-up, to grow thin after the childbearing and the (low) pelvic abdominal area suffers this pressure without being prepared, then they have to of this type of exercises is late after to the childbearing. On the other hand since it is a quite intimate topic it hides and is not consulted until the last years with what the problem worsens and delays his possible solution.
TREATMENT
To treat the urinal incontinence it is necessary to do a rehabilitation and strengthening of the muscles of the pelvis and if it is not sufficient it talks each other with surgery.
PELVIC REHABILITATION
Principally it is realized by means of the Kegel exercises:
The first thing is to try to identify the muscles to be contracted, for it it is recommended to sit in the toilet and to urinate, trying to stop the urine flow, and return to be urinated. Thus it is possible to have the sensation of the muscles to exercise. This exercise is already very advisable, to urinate and to retain, repeating it frequently. During this exercise they do not owe to contract other muscles of the area, like abdominal or glúteos. Another exercise is realized putting a finger in the vagina and to press it, trying to retain it inside. The same as the previous exercise must recur several times. The same exercise is done by a vaginal cone made with a plastic material of weight every time major that they interfere in the vagina and are retained by means of contraction of the musculature.
With these exercises one tries to avoid the fall of these devices the patient allowing to demonstrate what muscles it contracts in every moment and with what intensity.
TREATMENT BY MEANS OF SURGERY
When it is not sufficient with the rehabilitation, in 30 % of the cases, one resorts to the surgery to shorten and to tighten more affected muscles. It is realized by minimally invasive skills and by good pronóstico. /
Of course after the surgery the rehabilitation is needed again with the Kegel exercises and, sometimes to add temporarily some medication.
WHAT DOCTOR CAN TREAT ME?
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DENOMINATION 
