A little over five years ago a 52-year-old woman surnamed Chen started suffering from urinary incontinence, silently enduring it until her bladder became prolapsed. A hunk of tissue was stuck at her vagina’s vulva. When the situation worsened it got so bad that the tissue was as big as a chicken egg. Chen thought that walking and exercising would improve the condition, but it only made things worse, which was when she decided to have surgery and undergo therapy. “Since I had surgery I no longer have that sensation like something is stuck down there, and I urinate pretty good now,” Chen says.
Older women typically have problems with involuntary urination, which they rarely talk about. Chen would experience incontinence when she used stairs or sneezed, and when she would get the urge to urinate it would be too late by the time she got to the toilet, so she eventually stopped going out altogether. She also had to use sanitary pads if she absolutely had to leave the house.
Eventually Chen’s bladder protruded through the vaginal opening. In recent years, regardless of whether she was standing or walking, Chen would feel stabbing pains and discomfort. Her family and friends advised her that walking and exercising would help, so she started walking for an hour every day. Her prolapsed bladder ended up getting worse, which gave her the courage to finally have surgery.
Photo: Hsieh Fong-chiu, Liberty Times
照片：自由時報記者謝鳳秋
Liu Hsin-ho, a doctor in the urology department at Taichung Tzu Chi Hospital, says that stress incontinence usually occurs in older women, during menopause or after childbirth because the pelvic muscles and fascia become too weak to support the bladder. The more advanced a woman is in years the worse the situation is. Most patients at clinics are over the age of 70. Women who have natural, multiple or long childbirths, or regularly stand for a long time or do heavy lifting on the job are more likely to suffer from a prolapsing bladder, Liu says. It is atypical for someone like Chen in their 40s to experience this condition, Liu says.
Liu says that doing pelvic floor exercises like the Kegel exercise is the best way to prevent oneself from developing a prolapsing bladder. Persevering and doing the exercises as early as possible in life will get the best results, Liu says, adding that the degree of prolapse is greater the worse the condition is, which makes it more difficult for surgery to work.
(Liberty Times, Translated by Kyle Jeffcoat)
五十二歲陳女士五年多前就尿失禁，隱忍拖到膀胱脫垂，一團肉卡在陰道口，甚至惡化到像雞蛋那麼大，以為走路運動可改善，卻愈來愈糟才手術治療，她說：「術後終於沒有感覺卡卡的，排尿也不錯。」
女性長輩常有尿失禁難言之隱，像陳女士上下樓梯、打噴嚏就會漏尿，一有尿意即去廁所還是來不及，因此幾乎足不出戶，非得出門則需用護墊。
後來還出現膀胱脫垂卡陰道口，近年不管站還是走，總感覺刺痛、不舒服，親友勸她走路運動改善，天天走一小時，脫垂反而更嚴重，才鼓起勇氣接受手術。
台中慈濟醫院泌尿科醫師劉昕和指出，婦女「應力性尿失禁」好發跟年紀大、停經及生產造成的骨盆底肌肉及筋膜力量不夠有關，年紀愈大愈嚴重，門診常見患者多為超過七十歲，自然產、多產或產程過長婦女、長期久站、工作需拿重物者，也是好發族群，但像陳女士四十多歲就發病不多見。
劉昕和說，預防之道是做凱格爾運動這類的提肛運動，持之以恆，愈早做愈有效果，脫垂愈嚴重懸吊範圍愈大，手術愈不好做。
（自由時報記者謝鳳秋）
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