Lower urinary symptoms are quite frequent in adult females but medical attention is not seeked because of social stigma and embarrassment associated with it. Common urinary problems are incontinence (leakage of urine), urgency (going to the toilet frequently) and stress incontinence (leaking of urine with cough and laughing or straining.

Common causes of incontinence urine in female

  • Severe UTI
  • Over active bladder
  • Uro-Gynaelogical Fistula (VVF)
  • Pelvic Prolapse

Dr Amit K. Devra has done significant work in field of female urology. He has performed many incontinence surgeries with successful results.

It is a bacterial infection that occurs when bacteria invade the urinary tract system; the bacteria multiply throughout the urinary tract system. While the majority of urinary tract infections or UTIs are not serious, they often cause severe symptoms such as pain and/or burning upon urination. But when UTI is severe this may cause urinary urge incontinence.

Causes of Urinary Tract Infection

Urinary tract infections typically occur when bacteria enter the urinary tract through the urethra and begin to multiply in the bladder. Although the urinary system is designed to keep out such microscopic invaders, these defenses sometimes fail. When that happens, bacteria may take hold and grow into a full-blown infection in the urinary tract.

  • Infection of the bladder (cystitis). This type of UTI is usually caused by Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal (GI) tract. However, sometimes other bacteria are responsible.
  • Infection of the urethra (urethritis). This type of UTI can occur when GI bacteria spread from the anus to the urethra. Also, because the female urethra is close to the vagina, sexually transmitted infections, such as herpes, gonorrhea, chlamydia and mycoplasma, can cause urethritis.

Preventions for Urinary Tract Infection

You can take these steps to reduce your risk of urinary tract infections:

  • Drink plenty of liquids, especially water. Drinking water helps dilute your urine and ensures that you'll urinate more frequently ? allowing bacteria to be flushed from your urinary tract before an infection can begin.
  • Drink cranberry juice. Although studies are not conclusive that cranberry juice prevents UTIs, it is likely not harmful.
  • Empty your bladder soon after intercourse. Also, drink a full glass of water to help flush bacteria.
  • Avoid potentially irritating feminine products. Using deodorant sprays or other feminine products, such as douches and powders, in the genital area can irritate the urethra.
  • Change your birth control method. Diaphragms, or unlubricated or spermicide-treated condoms, can all contribute to bacterial growth.

In some patients, after gynecological surgery like laparoscopic hysterectomy or after obstructed labor an abnormal connection between vagina and urinary bladder or ureter is formed causing continuous urinary incontinence.

Urinary fistulas arising in a women is a complex and multi faceted problem. Apart from a cause of grave concern and psychosocial issues in the women herself, it can cause tension and emotional distress to the family, including the newborn if it is a case after child birth.

Urinary fistulas present as continuous urinary leakage in women. This chronic incessant leakage causes wetting, bad smell, skin soiling infections and may lead to the woman becoming a social outcast, either by choice or by societal pressure. Female urinary fistulas is a pertinent cause of incontinence or urinary leakage in women. Most women decline treatment because of embarrassment or shame.

Dr Amit K. Devra in Jaypee Hospital Noida specialising in Urogynecology in Noida and have special interest in the management of Gynecological Urinary fistulas like Vesicovaginal fistula (VVF) and Ureterovaginal fistula (UVF)

Vesico Vaginal Fistula Repair

In patient with vesicovaginal fistula, surgically bladder is opened and the abnormal connection (fistula) is dissected out. Then vaginal and bladder defect is repaired and both repair is separated by interposing other tissue in between to prevent recurrence. Usually drainage catheter is left for one to two weeks.

Pelvic prolapse is usually accompanied by some degree of vaginal vault prolapse. Vaginal vault prolapse occurs when the upper part of the vagina loses its shape and sags into the vaginal canal or outside the vagina. Pelvic prolapse may also involve sagging or slipping of other pelvic organs, including the bladder, the urethra which is the tube next to the vagina that allows urine to leave your body, and rectum.

Causes of Pelvic Prolapse

Pelvic prolapse results from the weakening of pelvic muscles and supportive tissues. Causes of weakened pelvic muscles and tissues include:

  • Pregnancy
  • Difficult labor and delivery or trauma during childbirth
  • Delivery of a large baby
  • Being overweight or obese
  • Lower estrogen level after menopause
  • Chronic constipation or straining with bowel movements
  • Chronic cough or bronchitis
  • Repeated heavy lifting

Treatments of Pelvic Prolapse

If Pelvic prolapse is severe, your doctor might recommend surgery. Minimally invasive (laparoscopic) or vaginal surgery might be an option.

  • Repair of weakened pelvic floor tissues. This surgery is generally approached through the vagina but sometimes through the abdomen. The surgeon might graft your own tissue, donor tissue or a synthetic material onto weakened pelvic floor structures to support your pelvic organs.
  • Removal of your uterus (hysterectomy). Hysterectomy might be recommended if uterine prolapse is severe.

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