Urinary incontinence (leaking urine)Urinary incontinence (peshab ka rissna)

Urinary incontinence kya hai

Urinary incontinence ka matlab hai bagair irade ke peshab nikal jana. Yeh khansne par chand qatray ho sakte hain, ya toilet pohanchne se pehle achanak bahut zyada peshab, ya musalsal tapakna. Yeh aam hai, aap ki ghalti nahi, aur zyada tar logon mein behtar ya theek ho sakta hai.

Bohat se log sharm ki wajah se saalon kisi ko nahi batate. Kuch gharanon mein ise bachay hone ya budhapay ka aam hissa samjha jata hai. Yeh dono nahi, aur madad mojood hai. Yeh guide batati hai ke bunyadi qismein kaun si hain, kya wajah hoti hai, kaise jaancha jata hai, kya madad karta hai, aur ilaaj ke kya intikhabat hain.

Meherbani karke sharmayein nahi. Doctors yeh roz dekhte hain. Aap aurat hon ya mard, aur kisi bhi umar ke hon, aap theek jaanch ke haqdar hain.

Yeh kitna aam hai

Urinary incontinence aam hai, khaas tor par auraton mein, hamal aur paidaish ke baad aur menopause ke baad, aur mardon mein prostate ke ilaaj ke baad. Yeh umar ke saath barhta hai, lekin kam umar logon ko bhi hota hai. Bohat se log kabhi madad nahi mangte.

Bunyadi qismein

Mukhtalif qismon ki wajohat aur ilaaj mukhtalif hote hain:

• Stress incontinence. Khansne, chheenkne, hansne, wazan uthane, daurne ya seedhiyan chadhne par peshab nikalna. Peshab rokne wale muscles aur tissues kamzor hote hain, is liye dabao peshab ko nikaal deta hai.
• Urge incontinence. Achanak, tez hajat ke saath toilet pohanchne se pehle peshab nikalna. Yeh overactive bladder hai (dekhein overactive bladder guide).
• Mixed incontinence. Upar ki dono saath saath.
• Overflow incontinence. Bladder theek se khali nahi hota, bohat bhar jata hai, phir musalsal tapakta hai. Yeh barhe hue prostate, stricture ya nason ke masail ke baad ho sakta hai (dekhein urinary retention guide).
• Musalsal rissna. Din raat bagair kisi ishare ke musalsal peshab rissna ghair-mamooli rabta (fistula, dekhein vesicovaginal fistula guide) ya paidaishi farq ki alamat ho sakta hai, aur maahir se jaanch zaroori hai.
• Functional incontinence. Is liye peshab nikalna ke insaan waqt par toilet nahi pohanch sakta, jaise chalne mein mushkil, dementia, ya toilet door hone ki wajah se.

Agar mushkil ya lambi paidaish ke baad, ya pelvic operation ke baad aap ka peshab musalsal rissta hai to meherbani karke jaldi doctor ko dikhayein. Fistula ka ilaaj ho sakta hai, aur yeh aap ki ghalti nahi.

Yeh kyun hota hai

Aam wajohat aur khatre ke asbab yeh hain:

• Hamal aur paidaish, jo pelvic floor ke muscles aur bladder ke rastay ke tissues ko kamzor kar sakte hain.
• Menopause, kyunke oestrogen kam hone se peshab ki nali ke ird gird ke tissues patle ho jate hain.
• Wazan ka zyada hona, aur purani khansi, jaise cigarette ya phephron ki bimari se.
• Qabz aur zor lagana.
• Mardon mein prostate ka ilaaj, jaise prostate cancer ka operation ya radiotherapy, ya barhe hue prostate ka operation.
• Barha hua prostate ya tang urethra jo bladder ko khali hone se rokta hai.
• Peshab ke infection, bladder ko tang karne wale mashroobat, jaise chai aur coffee, aur kuch dawayein.
• Nason ke masail, jaise stroke ya reerh ki haddi ki chot ke baad, ya diabetes mein (dekhein neurogenic bladder guide).
• Umar aur chalne mein mushkil.

Incontinence aap ki kisi ghalti se nahi hoti. Meherbani karke apne aap ko qasoorwar na thehrayen aur yeh na samjhein ke aap ko saza mili hai.

Tashkhees kaise hoti hai

Aap ke doctor aam tor par:

• Rissne ke baare mein poochhenge: kab hota hai, kitna, kitni baar, pehle hajat hoti hai ya nahi, kitne hamal hue, aur doosri bimariyan aur dawayein. Meherbani karke khul kar batayein, kyunke chhoti baatein ilaaj ki rehnumai karti hain.
• Bladder diary rakhne ko kahenge, kuch din tak: aap kya peete hain, kab peshab karte hain, aur kab peshab nikalta hai.
• Muaina karenge. Auraton mein is mein pelvic muaina aur mardon mein prostate aur neechle jism ka muaina shamil hai. Apni jins ke doctor ki darkhwast ki ja sakti hai.
• Peshab ka test karenge: infection aur cheeni ke liye.
• Dekhenge ke bladder kitna acha khali hota hai, aam tor par tez ultrasound se.
• Kabhi kabhi khaas pressure tests (urodynamics) ya bladder ke andar camera se jaanch karenge, jab wajah wazeh na ho, operation ka irada ho, ya pehle ilaaj nakaam ho gaya ho.

Meherbani karke pehli mulaqat par apni dawaon ki list, aur apne mashroobat aur toilet jane ka record saath layein.

Aap khud kya kar sakte hain

Yeh qadam bohat se logon ki madad karte hain, aur ilaaj ka pehla marhala hain:

• Pelvic floor exercises. Un muscles ko bheenchein jin se aap peshab rokte hain, kuch second tak rakhein, phir dheela chhor dein. Kai baar dohrayein, din mein kuch baar. In ki kuch mahine tak baqaidgi se mashq zaroori hai. Physiotherapist sahi muscles sikha sakta hai.
• Chai, coffee aur fizzy drinks kam karein.
• Kaafi pani peeyein, din bhar mein taqseem karke, aur sone se pehle kam. Meherbani karke mashroobat bohat zyada kam na karein.
• Agar wazan zyada hai to wazan kam karein.
• Cigarette chhor dein aur purani khansi ka ilaaj karwayein.
• Qabz ka ilaaj karein.
• Hajat ke liye bladder training: toilet jane mein dheere dheere der karein, jaise doctor ya physiotherapist batayein.
• Agar munasib ho to hajat ka intezar karne ke bajaye gharri ke hisab se toilet jayein.

Exercises sahi tareeqay se karna zyada karne se zyada ahem hai. Agar aap ko yaqeen na ho ke sahi muscles istemal ho rahe hain to physiotherapist ya doctor se poochein.

Ilaaj ke tareeqay

Agar khud ki dekh bhaal kaafi na ho to ilaaj incontinence ki qism par munhasir hai:

Meherbani karke incontinence ki qism theek se maloom hone se pehle operation ke liye haan na karein. Ghalat operation cheezein bigaad sakta hai.

Agar aap mard hain

Mardon mein incontinence aksar prostate ke operation ke baad, barhe hue prostate ke bladder khali na hone ki wajah se, ya nason ke masail se hoti hai. Prostate operation ke baad rissna aam tor par pelvic floor training se pehle kuch mahino mein behtar ho jata hai, aur bohat se mard bagair mazeed ilaaj ke theek ho jate hain. Agar na ho to intikhabat mojood hain, jin mein sling ya artificial urinary sphincter shamil hain, jo peshab ki nali ko kholne aur band karne wali cheez hai. Meherbani karke apne urologist se baat karein. Dekhein prostate cancer guide aur enlarged prostate guide.

Rissne ke saath zindagi, namaz aur rozmarra

Rissna aitemaad, samaji zindagi, kaam aur qurbat par asar daal sakta hai, aur bohat se logon mein safai aur namaz ki fikr paida karta hai. Yeh fikrein aam aur samajhne ke qabil hain. Meherbani karke inhein madad mangne se na rokne dein, kyunke ilaaj aksar masla kam ya khatam kar deta hai. Agar namaz ya tahaarat ke baare mein sawal hon to apne mazhabi aalim amli maamlaat mein rehnumai kar sakte hain, aur aap ke doctor rissne ko kam se kam masla banane mein madad kar sakte hain.

• Bahar jane aur lambay safar ke liye pads ya hifazati underwear istemal karein, aur kapron ka aik alag joda saath rakhein.
• Safar mein pehle se toilet ki jagah dekh lein, aur nikalne se pehle jayein.
• Jild saaf aur khushk rakhein, aur pads aksar badlein, taake rash aur infection se bachein.
• Rissne se bachne ke liye pani kam na karein. Is se cheezein bigarti hain.
• Kisi bharosay ke ghar wale se baat karein. Sahara madad karta hai.

Aam sawalaat

What urinary incontinence is

Urinary incontinence means leaking urine when you do not mean to. It can be a few drops when you cough, or a sudden flood before you reach the toilet, or constant dribbling. It is common, it is not your fault, and in most people it can be improved or cured.

Many people suffer for years without telling anyone, because of embarrassment. In some families it is considered a normal part of having children or growing old. It is neither, and help is available. This guide explains the main types, what causes them, how they are checked, what helps, and the treatment options.

Please do not be embarrassed. Doctors see this every day. Whether you are a woman or a man, and whatever your age, you deserve a proper check.

How common it is

Urinary incontinence is common, in women especially, after pregnancy and childbirth and after the menopause, and in men after prostate treatment. It becomes more common with age, but it affects younger people too. Many people never ask for help.

The main types

Different types have different causes and different treatments:

• Stress incontinence. Leaking when you cough, sneeze, laugh, lift, run or climb stairs. The muscles and tissues that hold the urine in are weak, so pressure pushes urine out.
• Urge incontinence. A sudden, strong need to pass urine, with leaking before you reach the toilet. This is the overactive bladder (see the overactive bladder guide).
• Mixed incontinence. Both of the above together.
• Overflow incontinence. The bladder does not empty properly, becomes too full, and then dribbles all the time. This can follow an enlarged prostate, a stricture or nerve problems (see the urinary retention guide).
• Constant leaking. Urine leaking all the time, day and night, with no warning, can mean an abnormal connection (a fistula, see the vesicovaginal fistula guide) or a birth difference, and needs a specialist check.
• Functional incontinence. Leaking because a person cannot get to the toilet in time, for example because of poor mobility, dementia or a long walk to the toilet.

If you leak constantly after a difficult or long childbirth, or after pelvic surgery, please see a doctor soon. A fistula can be treated, and it is not your fault.

Why it happens

Common causes and risk factors include:

• Pregnancy and childbirth, which can weaken the pelvic floor muscles and the tissues around the bladder outlet.
• The menopause, because lower oestrogen thins the tissues around the urine tube.
• Being overweight, and a long-standing cough, for example from smoking or lung disease.
• Constipation and straining.
• Prostate treatment in men, such as an operation or radiotherapy for prostate cancer, or surgery for an enlarged prostate.
• An enlarged prostate or a narrowed urethra stopping the bladder emptying.
• Urine infections, drinks that irritate the bladder, such as tea and coffee, and some medicines.
• Nerve problems, such as after a stroke or spinal injury, or with diabetes (see the neurogenic bladder guide).
• Age and poor mobility.

Incontinence is not caused by anything you did wrong. Please do not blame yourself or feel punished.

How it is diagnosed

Your doctor will usually:

• Ask about the leaking: when it happens, how much, how often, whether you feel an urge first, how many pregnancies you have had, and other illnesses and medicines. Please be open, because small details guide treatment.
• Ask you to keep a bladder diary for a few days: what you drink, when you pass urine, and when you leak.
• Examine you. In women, this includes a pelvic examination, and in men an examination of the prostate and the lower body. A doctor of your own sex can be requested.
• Test your urine for infection and sugar.
• Check how well the bladder empties, usually with a quick ultrasound scan.
• Sometimes arrange special pressure tests (urodynamics) or a camera look inside the bladder, when the cause is unclear, when surgery is planned, or when earlier treatment has failed.

Please bring a list of your medicines, and a record of your drinks and visits to the toilet, to the first visit.

What you can do yourself

These steps help many people, and are the first line of treatment:

• Pelvic floor exercises. Squeeze the muscles you would use to stop passing urine, hold for a few seconds, and relax. Repeat several times, a few times a day. They need regular practice for a few months. A physiotherapist can teach the right muscles.
• Cut down tea, coffee and fizzy drinks.
• Drink enough water, spread through the day, and less before bed. Please do not cut drinks too far.
• Lose weight if you are overweight.
• Stop smoking and treat a long-standing cough.
• Treat constipation.
• Bladder training for urgency: delay going to the toilet gradually, as your doctor or physiotherapist guides.
• Plan toilet visits by the clock instead of waiting for urgency, if this suits you.

Doing the exercises correctly matters more than doing a lot of them. If you are unsure that you are using the right muscles, please ask a physiotherapist or doctor.

Treatment options

If self-help is not enough, treatment depends on the type of incontinence:

Please do not agree to an operation before the type of incontinence has been properly worked out. The wrong operation can make things worse.

If you are a man

In men, incontinence most often follows an operation on the prostate, an enlarged prostate that stops the bladder emptying, or nerve problems. Leaking after prostate surgery usually improves with pelvic floor training over the first months, and many men get better without more treatment. If it does not, there are options, including a sling or an artificial urinary sphincter, a device that opens and closes the urine tube. Please talk to your urologist. See also the prostate cancer guide and the enlarged prostate guide.

Living with leaking, and prayer and daily life

Leaking can affect confidence, social life, work and intimacy, and for many people it raises worries about cleanliness and prayer. These worries are common and understandable. Please do not let them stop you from asking for help, because treatment often reduces or removes the problem. If you have questions about prayer or ritual cleanliness, your own religious scholar can advise on practical matters, and your doctor can help make the leaking as small a problem as possible.

• Use pads or protective underwear for outings and long journeys, and carry a spare change of clothes.
• Locate toilets in advance when travelling, and go before leaving.
• Keep skin clean and dry, and change pads often, to avoid rashes and infection.
• Do not cut down water to avoid leaking. It makes things worse.
• Talk to a family member you trust. Support helps.

Common questions