Urinary Incontinence in Women

Urinary incontinence is the sudden and involuntary release of urine from the urethra during normal daily activities. Urinary incontinence, which is observed in 15-20% of the entire female population, is a treatable condition. Urinary incontinence can develop in women of all age groups due to different reasons. However, urinary incontinence is definitely not a normal result of the aging process. Urinary incontinence is a condition that people cannot talk about easily. It can be embarrassing and uncomfortable. It can limit the activities you enjoy (exercise, traveling, social relationships, etc.) or it can be severe enough to limit daily life. Many solutions are now available for you to get rid of this problem, which can affect your professional, social and personal activities, and return to a free life and improve your quality of life.

Do I have incontinence?

  • When you laugh, cough or sneeze
  • When walking or exercising
  • When lifting a heavy object
  • You leak urine when you stand up from a sitting or lying position

Or

  • If you have to go to the toilet frequently throughout the day to get rid of this condition
  • If you have to use pads due to this situation

Or

  • If you cannot reach the toilet when you feel the urge to urinate
  • You have the feeling that you don’t always empty your urine completely in the toilet.

You should talk to a specialist about this issue. This will help you determine the cause and type of incontinence, if any, and take the first step towards the best treatment. Talking openly about urinary incontinence with your doctor or a specialist can help you learn about treatment options and regain the full and active lifestyle you once had.

What is the normal anatomy and functioning of the urinary tract?

The urine produced in the kidneys comes into the bladder (urinary bladder) through the ureters and collects in the bladder. When the bladder is full, a message is sent to the brain to empty the bladder. As the bladder muscles contract in response to the “emptying message” from the brain, the urine from the bladder is expelled through the urethra, the urinary tract, and the relaxation of the muscles. When the bladder is empty, the bladder muscles relax, the urethra contracts again and the bladder starts to fill again.

What are the types of urinary incontinence in women?

Urinary incontinence in women has been defined as 4 different types.

1)Stress Urinary Incontinence

Involuntary urinary incontinence with sudden movements such as laughing, coughing, sneezing, walking or exercising. It is the most common cause of urinary incontinence in women. There are two main causes; the first and most common one is weakness of the pelvic floor muscles. Pelvic floor muscles support the lower urinary tract organs. A strong pelvic floor keeps the urethra closed until it is time to urinate. When the pelvic floor is weak, situations that increase the internal abdominal pressure (exercise, coughing, etc.) cause the urethra to open and urinary incontinence. Risk factors include multiple intervention deliveries, giving birth to large babies, obesity, familial closeness and meeposis. Another cause of stress urinary incontinence is insufficiency of the internal sphincter muscles (muscles that control bladder emptying). Normally, the sphincter muscles keep the urethra closed while the bladder is filling and relax when it is time to urinate, allowing urination. In sphincter insufficiency, urine leakage occurs during various movements (coughing, exercise, etc.) because the muscles cannot do their job.

2) Urge Urinary Incontinence

It is a form of urinary incontinence when there is a strong urge to go to the toilet and you cannot reach the toilet. Unlike stress urinary incontinence, the cause is not weakness in the pelvic floor but overactive bladder muscles.

3)Mixed Urinary Incontinence

It is a combination of stress urinary incontinence and urge urinary incontinence.

4)Overflow Urine Incontinence

When urine is stored in the bladder above capacity, it is a small amount of urine incontinence without feeling difficulty urinating. The bladder remains full again. The person has the feeling that the bladder is not completely empty. Diabetes is caused by loss of muscle tone in conditions such as pelvic injury, extensive pelvic surgery, spinal cord injuries and multiple sclerosis.

Is the examination difficult when I consult a doctor for urinary incontinence?

When you consult a physician or a specialist in this field with a complaint of urinary incontinence, after discussing the medical history and urinary complaints, a detailed pelvic examination will be performed and some tests, especially urinalysis, will be performed according to the complaints and the characteristics of the examination. In addition to the simple tests that can be performed during the examination of the patient, more complicated urodynamic tests may be ordered by your doctor if necessary. In the diagnostic phase, very easy, simple and effective diagnostic devices are used, which are now available in modern urogynecology units and can be applied during normal examination and do not disturb the patient.

Before the diagnosis of urinary incontinence is made, the presence of a urinary tract infection, the use of medication that may affect the urinary tract (blood pressure medications, etc.) and some dietary characteristics (coffee, cola drinks, etc.) should definitely be investigated. Although urinary incontinence is a condition that can often be treated, not every treatment approach may be effective in everyone and in every type of urinary incontinence. Since the most appropriate treatment will be determined according to the type of incontinence, it is very important to determine the type of incontinence and make the correct diagnosis.

How is urinary incontinence treated?

Urinary incontinence can be treated at any age. However, not all treatment methods work for all types of urinary incontinence;

Treatment Methods for Stress Urinary Incontinence

– Behavioral / Muscle therapy:

The first step is kegel exercises, which are exercises to strengthen the pelvic floor muscles. With this treatment, the pelvic floor muscles are strengthened by controlling the muscles related to the bladder and urination. In addition to these exercises, a urinary diary is created and bladder training is tried to be provided within the framework of a program. Other treatment methods used in conjunction with these exercises or alone are Biofeedback and Electrical Stimulation. With these methods, weakened pelvic floor muscles are strengthened.

– Medication Therapy

Some types of urinary incontinence can be treated with medication or hormones. Especially in urge incontinence, the treatment option is drug therapy and drugs are used to reduce overactive muscle activity. However, stress urinary incontinence does not respond to drug treatment. In some cases, local estrogen creams, patches or tablets may be used, although this is rare.

– Surgical Treatment

If other treatment approaches have failed, surgery may be needed to address the underlying cause of urinary incontinence. There are many surgical intervention options and each is recommended according to the type or cause of incontinence.

-Bladder Neck Suspension Operations

– Retropubic Suspension (Burch,MMK)

– Needle Suspension (Stamey,Pereya,Raz)

– Suburethral Suspension (TVT, TVT Obturator, Vaginal Sling)

– Periurethral Plication Operations (Kelly, Kennedy)

– Periurethral Material Injections (Teflon, Silicone)

– Artificial Sphincters

– Nowadays, new methods have been developed that can be applied even under local anesthesia, are very simple, less invasive (with fewer incisions), can be applied in a very short time, are highly effective, and have a much shorter discharge and recovery period.

If you answer yes to any of the following questions, consult a specialist immediately. Because it is now much easier to get rid of these complaints to a great extent!

When you laugh , cough or sneeze

– When walking or exercising

– If you leak urine when lifting a heavy object, when you stand up from a sitting or lying position

Or

– If you have to go to the toilet throughout the day to get rid of this condition

– If you have to use pads because of this condition

Or

– If you cannot reach the toilet when you feel the urge to urinate

– You always have the feeling that you cannot empty your urine completely in the toilet

Consult a specialist immediately.