Urinary incontinence is the loss of bladder control, involuntary drops or more intense urine. Scientific studies reveal that 25 percent of women over the age of 18 miss urine. While this situation is seen in 10-15 percent of the youth, it rises to 35-40 percent in the 70s. Some data show that this rate has increased up to 70 percent in older ages.
Urinary incontinence is a health problem that is often hidden, not shared with even the closest, since it is described as “shameful” or seen as a natural result of old age, although it occurs so often. However, the problem grows over time, becoming a social problem that takes women away from the society and causes them to live introverted. First of all, the woman who handles her condition by using a pad stops giving way to travel away and then to closer visits. She can not spend a long time away from her home and toilet and gradually isolates from society.
URINE INCONTINENCE TYPES
Stress incontinence: It is the most common type of urinary incontinence in women. Urine is missed during various movements, such as coughing and exercise.
Urge (Jamming type) urinary incontinence: Urinary incontinence before reaching the toilet when it is necessary to go to a strong and urgent toilet.
Mixed Type Urinary Incontinence: In cases where stress urinary incontinence and urge urinary incontinence are combined, mixed urinary incontinence is mentioned. For example, when the patient coughs or sneezes, she may sometimes miss her urine after a sudden feeling of pinching.
Overflow urinary incontinence: When urine is stored above the capacity in the bladder, a small amount of urinary incontinence occurs without the need to urinate. The patient feels that she can never empty his bladder completely.
Total Urinary Incontinence: The patient states that he does not realize that she is leaking urine and that his underwear is always wet.
Functional Incontinence: Despite the incontinence problem in some patients, examinations are normally detected. This group of patients has causes such as Alzheimer’s, Parkinson’s or arthritis.
What are the Causes of Urinary Incontinence?
Bladder outflows can cause overactive bladder due to bladder infections, cystitis in women (bladder inflammation), vaginal infections, bladder stones, tumors, and prostate enlargement especially in men. Again, among the reasons that may cause constant urinary incontinence in women, affiliates (fistulas) that will occur between the bladder and vagina, or between the urinary tract (ureter) and vagina between the kidney and bladder. Diabetes and alcoholism may be among the reasons that can cause nerve damage in overflow urine incontinence.
Sometimes, rarely opening the urinary tract from the kidney to another place in the bladder (ectopic ureter) in girls can cause persistent urinary incontinence. While such children go to the normal toilet, they constantly urinate. Night (nocturnal) or daytime (diurnal) urinary incontinence in children is called enuresis. Compression in the spinal cord can lead to urinary incontinence and dysfunctions in children; constipation can predispose to infection and urinary incontinence.
Various surgeries in both sexes can lead to urinary incontinence. Among these reasons, surgery for prostate cancer especially in men, other prostate and bladder neck surgeries, surgeries around the bladder and sphincter, surgeries that may cause sphincter deficiency in women, fistula formation can be considered among such reasons.
Medicines can also cause or facilitate incontinence: These include medicines that relax to the muscle, blood pressure lowering medications, diuretics, tranquilizers, drugs against depression, allergy medications, and so on.
Diagnosis in Urinary Incontinence
In the treatment of urinary incontinence, determining the type of abduction is of great importance in terms of treatment. In addition to the examination, your doctor may order some tests to confirm the diagnosis of incontinence. The tests are of great importance for the correct treatment. These tests are:
- Urine Culture
- Urine Flow Rate
- cystogram
- cystoscopy
- urodynamics
How is urinary incontinence treated?
The most accurate treatment will be determined by the type of urinary incontinence. Because not every treatment approach may be effective in every type of urinary incontinence. Treatment alternatives are:
Kegel exercises
Exercises to strengthen the pelvic floor muscles are effective in some cases alone but generally as an auxiliary method. With this treatment, the pelvic floor muscles are strengthened by ensuring the control of the bladder and urination muscles. In addition to these exercises, a diary (urine diary) is created and bladder training is tried to be provided within the framework of this program. Electrical stimulation with these exercises, or with a biofeedback applied alone, is also effective in strengthening the weakened pelvic floor muscles.
Medication
Some types of urinary incontinence are treated with medications or hormones. Drug treatment is the first option especially in urge incontinence type. The duration of drug therapy varies from patient to patient.
Surgical treatment
When other treatment approaches fail, surgical intervention is performed. Nowadays, very simple, less invasive (made with fewer incisions), very effective, very effective, shorter period of discharge and recovery, which can be applied even under local anesthesia. In the TOT (Transobturator Tape) method, a tape that is closed under stress is placed in the middle of the urinary tube, the patient is sent home without catheter on the same day or the next day.
Injections Around The Urethra (Urine Pipe)
Various substances are injected under the local anesthesia to the periphery of the urinary tract in patients who cannot undergo surgery or benefit. These are substances of different protein or chemical structure called collagen, polytef or macroplasty.
Botox Injections
In this very new method, botulinum toxin is injected into the bladder muscle and temporary relaxation is provided in the bladder muscles of the bladder, so that urinary incontinence or urinary incontinence is tried to be treated.
WHEN TO CONSULT A DOCTOR?
- If your answer to one of the questions below is “yes”, consult a Urologist.
- When you laugh, cough or sneeze; while walking or exercising; when lifting a heavy item; you are passing urine when you stand up sitting or lying down.
- If you have to go to the toilet frequently during the day.
- If you have to use pads due to these problems.
- If you cannot reach the toilet when you feel urinated.
- If you feel that you can never completely empty your urine in the toilet.
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