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Urinary Incontinence in Female

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The urinary incontinence is an involuntary loss of urine. It is a disease that affects one in three women of all ages, which means more than 30 million people in India and more than 350 million worldwide. It is not a normal process associated with aging, and it has a negative impact on the quality of life of women who suffer from it.

What is urinary incontinence?

The urinary incontinence is the involuntary loss of urine. Urine losses are not a normal process of aging, so it is advisable to consult an expert professional. In most cases, urinary incontinence has a solution and does not have to condition daily and social life.

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Types of Urinary Incontinence

There are different types of urinary incontinence that respond to different causes, so it is important to make a correct diagnosis to adapt to the treatment.

You may have symptoms that belong to one or several of the types simultaneously. The most frequent types of urinary incontinence in women are:

Urinary incontinence of effort. The loss of urine occurs when you laugh, sneeze, practice an exercise, gain weight or simply stand up.

The frequency and severity of losses vary greatly from one woman to another. Some have occasional leakage of urine and others, more often. The amount of urine that is lost is also very variable in each woman, from a few drops to a jet.

The origin of this type of incontinence occurs when making an effort increases the pressure in the abdomen and bladder. This causes the urine to exit involuntarily through the urethra (the tube where urine exits to the outside), especially when the support to the urethra is weakened.

Urinary incontinence of urgency. There are people who suddenly feel a strong urge to urinate without being able to control it (urgency). This symptom is usually accompanied by an increase in urinary frequency, both day and night (nocturia). The person who suffers urinary urgency is unable, in many cases, to retain urine before reaching the bathroom.

Mixed urinary incontinence. It is the association of symptoms of two types of incontinence: that of effort and that of urgency.

Overactive bladder. The main symptom of overactive bladder is the sensation of urgency, aggravated by an increased desire to go to the bathroom (increased urination frequency). It seems to have the same origin as urge urinary incontinence.

How many people does Urinary Incontinence affect?

It is estimated that between 30% -40% of women can have involuntary leaks of urine, even occasionally, even so, some are more likely to suffer urinary incontinence than others.

Risk factors of Urinary Incontinence

There are different risk factors that can precipitate or aggravate urinary incontinence:

Non-modifiable factors

Genetics. Some women are born with a pelvic floor musculature that is weaker or more susceptible to weakening. There is a greater chance of incontinence if there is a family history.

Pregnancy. The hormones released during pregnancy relax the tissues and produce stretching of the pelvic floor muscles. In addition, the increase in weight as the baby grows affects the pelvic floor musculature at the time of maintaining the continence function optimally.

Parto. During childbirth, the pelvic floor muscles that hold the bladder, vagina, and rectum, suffer the maximum stretch possible due to the pressure exerted on the head of the baby to descend to exit through the vagina. In some women, these muscles and the tissues that surround them, can be permanently laxer, and weaken these structures that lead to urinary and anal incontinence.

Menopause. In this stage of life, due to hormonal change, different changes can occur that precipitate or aggravate the symptoms of incontinence and other pelvic floor problems.

Gynecological surgery. A gynecological surgery, such as extirpation of the uterus (hysterectomy), or other therapeutic procedures at the pelvic level, such as radiation therapy, may cause alterations of the nerves or anatomical structures that maintain continence. These variations can precipitate or aggravate the symptoms of urinary incontinence or cause a feeling of a bulge in the genitals by the descent of the pelvic organs (prolapse).

Modifiable factors

Obesity. It is demonstrated that overweight and obesity are risk factors for stress urinary incontinence, due to the increase of pressure inside the abdomen and, therefore, over the bladder. This effect can also contribute to the appearance or worsening of other problems related to the pelvic floor, such as the descent of the pelvic organs (prolapse) or urge urinary incontinence.

Chronic constipation. The increase of the abdominal efforts to obtain the correct evacuation exerts pressure on the pelvic structures and distension on the pelvic floor musculature, which causes it to weaken.

Tobacco. There is evidence that tobacco is a risk factor for stress urinary incontinence since its habitual consumption favors the appearance of chronic cough and this causes an increase in abdominal pressure.

Bladder stimulants. The excessive intake of some substances (caffeine, alcoholic beverages, soft drinks, and sweeteners) produce an excessive stimulation of the bladder, which worsens the symptoms of urgency and increases the urge to go to the bathroom.

Drinking a lot. Excessive intake of fluids (more than 1.5 liters per day) can condition the onset or worsen of incontinence.

Physical efforts. Some of the behaviors that are performed during the day involve repeated physical efforts, whether at work, hobbies, body posture, etc. This conditions an increase in abdominal pressure and overload of the pelvic floor structures, which can precipitate or aggravate the symptoms of stress incontinence. They have more risk, women who practice impact sports, stop and start sports, weights, push-ups, etc.

Treatment of Urinary Incontinence

Sometimes, women who experience urinary incontinence do not give importance because it occurs very occasionally, in very small amounts, or, it does not interfere with their well-being, so they do not need to consult or receive any treatment. In contrast, in other women, urinary incontinence is a detriment and, therefore, they need to know the treatment options available for each type of incontinence.

A high percentage of women with urinary incontinence who receive treatment, personalized and indicated by specialized professionals, achieve a cure or an important improvement of the symptoms.

There are multiple treatments for urinary incontinence. Depending on the characteristics of the patient, the symptoms and the severity of the incontinence, one or another treatment or the combination of several is chosen.

Conservative treatment

Conservative treatment includes a set of measures that do not require surgery or medication. It is recommended to all women, regardless of the type of incontinence they have.

Lose weight. In women who are overweight or obese, it is shown that a weight reduction of between 5 and 10% can reduce the episodes of weekly urinary incontinence by up to 50%. For this reason, it is recommended to lose weight with the help of diet and exercise.

Improve intestinal transit. Decrease the efforts to defecate with dietary guidelines that improve chronic constipation, avoid the weakening of the pelvic floor musculature.

Give up smoking. Chronic cough decreases, so episodes of urinary incontinence will be less frequent since there is less impact on the muscles of the pelvic floor. In addition, tobacco acts as a bladder stimulant, so it will also improve symptoms of urgency.

Reduce or eliminate the use of bladder stimulants. Coffee and tea, alcohol, soft drinks, sweetened drinks, energy drinks, etc., produce spasms in the bladder. Reducing its consumption is beneficial for those women who have symptoms of urgency and increased urination frequency.

Moderate fluid intake. The adequate consumption of liquids should be around 1.5 liters a day. It must be taken into account that a balanced diet already contributes a part of the necessary hydration. Therefore, people with urgency or nighttime incontinence should avoid drinking liquids after mid-afternoon.

Control of physical efforts. It is important to practice daily physical exercise. However, those women with stress urinary incontinence, or with significant muscle weakness, should avoid making physical efforts that pose a risk to the pelvic floor musculature. In this sense, exercises such as walking, swimming and all those that help to acquire a good physical shape without causing abdominal pressure are recommended.

As a precautionary measure, whenever physical exercise is practiced, a contraction of the pelvic floor muscles should be performed in order to counteract the abdominal pressures and avoid possible episodes of urinary incontinence.

Training program for the pelvic floor musculature. The objective of these exercises is to strengthen the muscles surrounding the vaginal and anal areas to increase control of urine losses in women. It is not recommended to perform the exercises of the pelvic floor musculature without prior advice from professionals.

Devices. There are other devices that help improve urinary incontinence such as cones and vaginal spheres, pessaries or tampons for urinary incontinence.

Pharmacological Treatment

Pharmacological treatment is useful for women diagnosed with urge urinary incontinence or overactive bladder. Currently, there are several drugs available that decrease the involuntary spasms of the bladder and relax the muscle that contracts the bladder. However, some drugs are contraindicated in patients with glaucoma, pyloric stenosis, severe bronchospasm, reflux esophagitis, intestinal ileus, severe ulcerative colitis, as well as in patients with hypertension. Not controlled. After starting a pharmacological treatment, it is advisable to go to a control visit after four weeks to assess the suitability of the treatment. If there is an improvement, continue with the drug and if there is not, or it is minimal, you can change the dose of the same drug or try a new one.

Surgical Treatment

Stress urinary incontinence

This type of treatment is indicated in women with severe or moderate urinary incontinence who do not want conservative treatment, or when this has not been effective.

Currently, the choice of surgical technique to correct the symptoms of stress urinary incontinence is based on the characteristics of each patient and the experience of the surgical teams that apply these treatments.

Tension-free band. It is the most widely used technique and involves placing a tape that passes under the urethra (urine outlet duct) to get more support during the efforts and avoid leaking urine.

Complications are minimal and recovery is rapid, so in most cases, it does not require hospital admission.

There are other less complex techniques that can be used, in case of not responding to the usual technique, or when the specialized professional considers that, given the characteristics of the patient, there may be another more appropriate.

Mixed urinary incontinence

The treatment of these women is complex and requires a very high degree of personalization, as well as a very complete study.

The nephrologist in Delhi is responsible for assessing the characteristics of each woman and the severity of the symptoms. Based on this, sometimes, it begins with treating the symptoms of urgency, and other times, the symptoms of exertion. And, on other occasions, both symptoms are treated from the beginning.

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Signs That My Kidneys Are Not Working Well

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The kidneys are responsible for filtering our blood, helping to eliminate toxins and purify our body, which is why its proper functioning is fundamental to our health. But diverse conditions can compromise their well-being, detecting them in time is important to find the opportune treatment and guarantee that our body stays always healthy.

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Conditions such as kidney stones, infections, nephritis or kidney failure can affect these important organs, compromising our health. Do you know how to detect that they are failing? In this article, we reveal some signs that your kidneys are not working well, pay attention to them!

What is the function of the kidneys?

The adequate renal function is very important to guarantee our general health since these organs fulfill important functions in the purification process of our organism.

Some of the functions of the kidneys are:

  • Purify the blood eliminating waste, toxins, excess water, medication, etc. All these elements are filtered and converted into a liquid that will be stored in the bladder and then expelled in the form of urine.
  • Regulate the amount of calcium in our blood as well as the production of vitamin D. When we eat a lot of calcium in the diet or through supplements, it is possible that the kidneys do not manage to eliminate it effectively, thus giving rise to the formation of kidney stones composed mainly of this mineral.
  • Regulate the amount of acids present in our bodies to prevent them from accumulating and causing health problems.
  • Release the hormone renin, responsible for regulating blood pressure.
  • Release erythropoietin, a hormone that stimulates the production of red blood cells.

Conditions that can affect our kidneys

Because they are one of the purifying organs of the body when the balance we need to function properly is lost we run the risk of suffering from various conditions that affect our kidneys and therefore our general health.

Some common kidney diseases are:

  • Kidney stones or stones occur when calcium, uric acid or struvite accumulate in the body and cannot be adequately eliminated through urine.
  • Infections in the urinary tract or pyelonephritis. The infection originates in the urethra or bladder and, if left untreated, goes up to the kidneys, affecting its functioning.
  • Renal insufficiency, a chronic disease through which the ability to filter blood by the kidneys is slowly lost.
  • Kidney Cysts
  • Cancer in the kidney.

Symptoms that your kidneys do not work well

Our body is a highly efficient machine, and when one of the components of the gear does not run properly the body begins to send small signals. Some of them can be ignored or confused with other conditions, however, if you present one or more of the following symptoms it is best to go to a nephrologist in Delhi for a review. A blood test and a urine sample are enough to detect kidney function problems.

Some signs that your kidneys do not work well are:

Important changes in urine

Because the kidneys are responsible for producing urine, when the operation of the kidneys is not adequate, it is common to notice important changes in urination. Conditions may vary depending on the problem, but some of the signs you may notice are:

  • Urinating much more frequently, it becomes common to get up at night to urinate and go to the bathroom very often during the day.
  • On the contrary, it may happen that you urinate less frequently and that the liquid has a very dark color or a cloudy appearance.
  • Blood in the urine.
  • Bad smell in urination.
  • A sensation that you do not completely empty the bladder.

Bloated body

Due to the fluid retention that occurs because the kidneys are not working properly, it is common to notice the inflamed body especially in areas such as the ankles, feet, abdomen, face or hands.

Pain in the lower back or side

This is one of the signs that the kidneys do not work well more common. It occurs in patients with conditions such as kidney stones, urinary infections, and even kidney failure.

Tiredness and unexplained fatigue

As we explained earlier, one of the functions of the kidneys is to produce erythropoietin, a hormone that interferes with the production of red blood cells. When there are problems in the kidneys the levels of this hormone are affected and therefore the number of red blood cells in the blood decreases, also reducing the oxygen that our organs receive including the brain. Patients begin to suffer from anemia, and this is the reason why they feel tired and have difficulty concentrating for no apparent reason.

Rashes and itchy skin

This can be a sign of kidney failure because the kidneys are responsible for eliminating toxins from the body, by not doing properly they happen to accumulate in the body affecting the appearance and health of the dermis.

Nausea and vomiting

It also happens due to the accumulation of toxins in the body, the body is unable to eliminate waste and tries to do it in other ways, for example through vomiting. This, in turn, causes loss of appetite and therefore involuntary weight loss.

Bad breath and a metallic taste in the mouth

Due to the accumulation of waste in the body, those who suffer from the kidneys usually perceive a metal taste in the mouth accompanied by bad breath. It may also be common to begin to repel foods such as meat.

Other symptoms that may indicate that your kidneys are not well are:

  • Feeling of frequent cold, even when it is hot. This is due to the anemia that patients with this condition usually suffer.
  • Feeling short of breath when performing simple activities such as walking a bit. This may be caused by the lack of cellular oxygenation.
  • Problems of concentration or lack of memory, also due to the lack of oxygenation of the brain.

If you notice several of these symptoms, it is best to go to a kidney specialist in Delhi for a general review that includes blood and urine tests, which will determine if there is any condition linked to the kidneys.

Determination of Urea in the Blood

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Definition of Urea

The urea is a molecule which results from a process of protein degradation. It is the main form of elimination of nitrogenous waste by urine. It is the nitrogen of the proteins which, combined with molecules produced by the liver, constitutes the urea.

Why make dosage of urea?

The urea assay allows, along with other measurements, to evaluate renal function, especially the presence of renal failure. It is also prescribed to monitor the renal function of people with diabetes or having suffered a myocardial infarction. Indeed, when the kidneys are not functioning normally, there is an increase in the blood concentrations of urea, creatinine and uric acid. Some liver conditions can also affect the level of urea in the blood.

The dosage of urea alone in the blood is however not very informative, because the amount of urea produced each day varies according to the diet and its excretion by the kidneys is irregular. The determination of creatinine is therefore generally preferred or at least performed at the same time.

Urea can also be evaluated in the urine (“clearance” of urea). Urine urea/blood urea ratio can help the nephrologist in Delhi determine the cause of kidney failure. In addition, the urea assay can be used to evaluate the effectiveness of dialysis.

What results can be expected from a urea assay?

The dosage of urea in the blood (uremia) is performed on a blood sample, usually performed at the bend of the elbow.

It should preferably be fasting and avoid meals too rich in protein the previous days.

The urine urea (uricemia) dosage is 24 hours.

What results can be expected from a urea assay?

Normal values ​​for urea in the blood range from 2.5 to 7.6 mmol / L (or 0.10 to 0.55 g / L).

In children and pregnant women, these values ​​are lower.

In the urine, urea is found at 300 to 500 mmol / 24 hours.

The concentration of urea increases abnormally in various situations, including:

  • in case of kidney failure or kidney damage
  • in case of infections, cardiovascular accident, shock, stress, etc.
  • when taking certain medications
  • in case of very high protein diet

Decreased urea levels may be a sign of dietary protein deficiency, for example, gastrointestinal malabsorption, or severe liver disease.

Top Reasons to Visit the Best Nephrologist in India

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Top Reasons to Visit the Best Nephrologist in India

A diagnosis of kidney problem means frequent doctor visits, lab tests, dialysis, change in diet and even kidney transplant in the future. Diet and medications can hold these kidney problems if followed regularly. Listening to the advice of best nephrologist in Delhi is extremely important for a kidney patient at any stage of the disease. Early diagnosis of the problem can slow down the disease occurrence and even results in stoppage from advancing. Nothing can be done to cure the problem if it becomes more serious. Nephrologist in Delhi plays an essential role in making decisions in relation to withholding or withdrawing treatment related to kidney patient.

Kidney infection is another main cause of kidney failure. If you are suffering from diabetes and experiencing urine problem it is advisable to visit kidney specialist in Delhi, India. Diabetes causes damage to the small blood vessels. It also damages the nerves in the bladder causing pressure on the kidney. This results in either infection in the kidney or kidney failure. Best kidney specialist in Delhi suggests the diabetic patient keep an eye on the symptoms. The most common symptoms are at a high level of protein in urine, swelling, itchiness, tiredness, and breathlessness. It is advisable to immediately visit the best kidney hospital in India to get the best treatment to cure this problem.

Early discovery of the disease can be lifesaving. Early detection of the problem can work the best to control the condition. But if the problem is in its last stage organ transplant is the only option left. This is the process carried out to place a healthy kidney in the body of the patient suffering from failure. Kidney transplantation by kidney doctor in Delhi offers improved value of life since it lets greater freedom and higher energy level than before. However, there are certain complications like the rejection of new kidney also occurs. To prevent these complications best nephrologist in Delhi follow their patients regularly for a year after the surgery. If you are experiencing such symptoms or have any issues related to your kidney it is best advisable to have an immediate visit best nephrology hospital in India to get excellent treatment and happier years to your life.