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Són tiểu ở nam giới, nguyên nhân và cách phòng ngừa

Có khoảng 3-5% nam giới mắc chứng són tiểu và tỷ lệ này tăng lên theo tuổi, 10% ở tuổi 60 và 30% ở tuổi 90. Nam giới mắc chứng bệnh này gặp phải không ít buồn phiền, ảnh hưởng rất lớn tới đời sống hàng ngày nói chung và tâm lý nói riêng.

Són tiểu là gì?

Bạn chớ vội nhầm són tiểu với triệu chứng có ít giọt nước tiểu rớt lại sau khi đã tiểu tiện xong nhé. Vì són tiểu là tình trạng nước tiểu tự rỉ ra không kiểm soát được. Điều này thường xảy ra khi bạn gắng sức hay khi bạn có cảm giác tiểu gấp, buồn tiểu và hay xuất hiện vào cuối ngày. Có người đã phải nghĩ ra nhiều cách kể cả việc lót băng vệ sinh của phụ nữ để tránh tình trạng nước tiểu rỉ ra quần áo không kiểm soát. Điều này khiến cho bản thân họ cảm thấy phiền phức và gây ức chế tâm lý.

Són tiểu ở nam giới làm giảm đáng kể chất lượng cuộc sống của người bệnh.

Vì sao nam giới bị són tiểu?

Có nhiều nguyên nhân dẫn tới tình trạng són tiểu – tiểu không tự chủ ở nam giới, nhưng thường gặp nhất là ở một số người bị tiểu đường, xơ hóa rải rác, đột quỵ, có vấn đề ở bàng quang… Thậm chí là nguyên nhân không rõ ràng ở một số trường hợp sau:

  • Són tiểu do bàng quang tăng hoạt: Nguyên do, cơ bàng quang co bóp quá mức gây són tiểu, không thể kìm nén được nước tiểu. Thường gặp ở người bị phì đại tuyến tiền liệt hoặc bàng quang thần kinh (chức năng của bàng quang bị mất do nguyên nhân thần kinh…).
  • Són tiểu do thiểu năng cơ thắt: Nguyên nhân này thường thấy sau mổ ung thư tuyến tiền liệt hoặc sau mổ u xơ tuyến tiền liệt.
  • Són tiểu do ứa tràn nước tiểu: Nguyên nhân này liên quan đến chứng bí tiểu mạn tính do bít tắc (phì đại tuyến tiền liệt) hay bất đồng vận của điều khiển thần kinh khi đào thải nước tiểu.

Chẩn đoán són tiểu ở nam giới có khó?

Vì són tiểu ở nam giới có nhiều nguyên nhân nên khi thăm khám bác sĩ sẽ hỏi nhiều về tiền sử bệnh. Ví dụ như: Người bệnh đã trải qua các phẫu thuật hoặc từng bị chấn thương vùng tiểu khung, có các bệnh liên quan ở trước đó. Những loại thuốc mà bệnh nhân đang dùng cũng như hoàn cảnh và mức độ són tiểu, mức độ chứng són tiểu ảnh hưởng đến chất lượng đời sống cũng cần được quan tâm.

Bác sĩ sẽ tiến hành khám vùng hố thận, khám bụng tìm dấu hiệu “cầu bàng quang”, thăm trực tràng. Thực hiện, xét nghiệm chức năng thận, nước tiểu, PSA…

Ngoài ra, để chẩn đoán chính xác cần làm thêm các khám nghiệm đặc hiệu khác như: Soi hoặc chụp bàng quang niệu đạo, niệu động học, chẩn đoán hình ảnh hệ tiết niệu cho phép xác định nguyên nhân.

Nguyên tắc trong điều trị són tiểu?

Việc điều trị bệnh này phụ thuộc rất nhiều vào nguyên nhân gây bệnh.

  • Són tiểu do bàng quang tăng hoạt

Nếu bị són tiểu do nguyên nhân này, người bệnh sẽ được điều trị nội khoa bằng Anticholinergiques. Ngoài ra, gần đây trên thế giới đã áp dụng phương pháp cấy bảng kích thích điện cực thần kinh bàng quang tại vùng xương cụt đã đem đến kết quả khả quan. (Trích nguồn tham khảo)

  • Són tiểu do thiểu năng cơ thắt

Với nguyên nhân són tiểu này thì việc luyện tập phục hồi chức năng luôn phải được đặt lên đầu tiên. Nguyên tắc là tập co thắt các cơ vùng tầng sinh môn: Sau từ 6 đến 12 tháng mà việc luyện tập phục hồi chức năng không có kết quả thì cần phẫu thuật.

  • Són tiểu liên quan đến phì đại lành tính tuyến tiền liệt

Với chứng són tiểu liên quan đến phì đại lành tính tuyến tiền liệt thì ban đầu có thể điều trị nội khoa với các thuốc đông hoặc tây y. Nếu không hiệu quả thì phải dùng phẫu thuật.

  • Són tiểu do bí tiểu mạn tính

Để điều trị són tiểu do nguyên nhân này thì phải dựa trên nguyên tắc loại bỏ sự tắc nghẽn nếu có, như: Nội soi cắt tuyến tiền liệt hay phẫu thuật hẹp niệu đạo. Với trường hợp bàng quang thần kinh thì có thể áp dụng biện pháp tự đặt ống thông niệu đạo bàng quang hằng ngày.

Phòng ngừa són tiểu ở nam giới theo nguyên nhân gây bệnh

  • Són tiểu do thiểu năng cơ thắt: Hiện tượng són tiểu này xảy ra sau phẫu thuật tuyến tiền liệt do tổn thương cơ thắt niệu đạo. Cách dự phòng tốt nhất là tránh làm tổn thương cơ thắt khi mổ. Nhưng với phẫu thuật loại bỏ ung thư tuyến tiền liệt, phải cắt rộng rãi thì nhiều khi khó tránh khỏi việc làm tổn thương cơ thắt. Nếu xuất hiện són tiểu sau phẫu thuật thì bệnh nhân cần kiên trì tập co thắt cơ thắt niệu đạo trong một thời gian, có khi kéo dài cả năm.
  • Són tiểu do bàng quang tăng hoạt: Ở trường hợp này, bàng quang co bóp quá mức ngay cả khi chưa đầy nước tiểu dẫn đến són tiểu. Người bệnh luôn cảm thấy buồn tiểu quặn lên trước khi són tiểu, nhất là khi rửa tay hay nghe thấy tiếng nước chảy. Dự phòng bằng việc tập điều khiển sự co giãn của các cơ bàng quang, cơ sàn chậu, điều tiết sự đi tiểu theo bài tập được bác sĩ chuyên khoa hướng dẫn.

Bài tập như sau:

  • Giả vờ như đang cố gắng ngưng tiểu (nhịn tiểu).
  • Giữ sự co thắt cơ vùng chậu như thế trong mười giây, sau đó thả lỏng trong mười giây.
  • Lặp lại bước 2 vài lần nữa và tập như vậy nhiều lần trong ngày.

Người bệnh nên tập động tác này mọi lúc, mọi nơi, kể cả khi đang ngồi, khi đọc báo, tán gẫu hay đang làm vườn…

Cần chuyên gia hỗ trợ thêm về cách phòng và trị tiểu són, vui lòng liên hệ Tổng đài 1800 6523 để được tư vấn.

TKS Tiền Liệt Tuyến

Bài viết đã được soạn thảo, kiểm tra và phê duyệt bởi đội ngũ bác sĩ, dược sĩ , giáo sư từ Viện Y Học Bản Địa Việt Nam với đại diện là Bác sĩ Hoàng Sầm – Chủ tịch Viện,  phó chủ tịch hội Nam Y Việt Nam.

Hỏi đáp cùng bác sĩ Giải đáp trực tiếp

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