Women who are older, who have had a difficult or multiple birth, or who have weak pelvic area muscles urinary incontinence in women It is seen very often. This situation reflects negatively on daily life.
It is very common in post-menopausal women. They are afraid to even go out for fear of urinary incontinence. While some women with urinary incontinence prefer to seek medical support due to the distress they experience, others accept this condition as a normal effect of aging and do not seek medical support.
Urinary incontinence in women is a condition that the patient cannot control. The patient cannot hold his urine. This condition is medically called urinary incontinence. It is a disease that can occur at any age, but is more common in the elderly.
Kiss. Dr. Serhat Donmezer urinary incontinence in women He answered your questions about your problems. You can find the answers to your questions in the rest of the article.
Risk Factors for Urinary Incontinence in Women
Urinary incontinence in women It can occur due to many reasons. Some of these reasons are;
Age
The muscles that form the pelvic floor, contract and prevent urinary incontinence, weaken with age. When the lower abdomen becomes weak, urinary incontinence may occur. According to research, it has been observed that urinary incontinence increases after the age of 54 and the risk of stress incontinence begins after the age of 35.
Pregnancy and Birth
Obesity
Chronic Constipation (Constipation)
What kind of complications occur after urinary incontinence?
Causes of Urinary Incontinence in Women
- Familial predisposition. If the mother or sisters have it, the risk increases threefold.
- Advancing age.
- Pregnancy, childbirth, difficult or invasive births
- Previous gynecological surgeries
- Receiving radiation therapy for cancer
- Frequent urinary tract infections, cystitis
- drinking too much alcohol
- Herniated disc, dementia, multiple sclerosis affecting the nerves of the bladder
- entering menopause
- chronic constipation
- Diabetes, high blood pressure, heart disease, chronic lung disease
- Being overweight or obese.
- Inactivity, sedentary lifestyle
Types and Symptoms of Urinary Incontinence in Women
There are different types of urinary incontinence, such as persistent urinary incontinence, stress type, urge type, mixed type, nocturnal enuresis (urinary incontinence during sleep), functional type, and overflow type urinary incontinence.
- Stress Incontinence: It is urinary incontinence that occurs as a result of increased intra-abdominal pressure reflecting on the bladder during events such as coughing, sneezing, heavy lifting.
- Urge Incontinence: It is a condition of involuntary urinary incontinence (inability to urinate) after a sudden urge to urinate. Urge incontinence is the most common type of urinary incontinence in elderly patients.
- Mixed Type Incontinence:
- It is the combination of both stress type and neurogenic type.
- Nocturnal Enuresis: It is a type of urinary incontinence that means the inability to control urine after sleeping at night.
- Overflow Urinary Incontinence: This happens because the bladder is overstretched. Frequent or persistent leaking and dripping urinary incontinence is the main symptom.
- Functional Incontinence: Even though there is no problem in the urinary tract or bladder, urinary incontinence occurs when the patient does not go to the toilet on time. It occurs due to physical or cognitive limitations.
Since foods and drinks consumed during the day have diuretic properties, urinary incontinence may sometimes occur. Temporary urinary incontinence occurs when the amount of urine increases and the bladder is stimulated.
Medications such as alcohol, caffeine, carbonated and acidic drinks, artificial sweeteners, spicy and bitter foods, sedatives and muscle relaxants can cause temporary urinary incontinence.
Urinary Incontinence Diagnostic Methods
• Diagnosis of urinary incontinence begins with the patient's medical history. The type of incontinence is evaluated by examining when the symptoms started, the degree of incontinence, and which factors increase and decrease. Evaluation of neurological disorders and anatomical abnormalities that may contribute to urinary incontinence, as well as a physical examination by a physician, play an important role in the diagnosis phase.
• Stress testing is used to evaluate the presence of urinary incontinence when a person with urinary incontinence coughs with a full bladder.
• One of the methods used for diagnosis is the urine diary. Urinary incontinence status and frequency are recorded in the chart.
• Urinalysis and biochemical analysis are laboratory analyzes that provide information about the presence of infection and kidney capacity.
• Ultrasound imaging checks for obstructive conditions such as tumors and stones in the bladder and urinary tract. USG uses a test called PVR, which is performed a few minutes after the person has urinated. The PVR test measures the amount of urine left in the bladder after a person urinates.
• Urodynamic tests, which measure bladder pressure, and urethrocystoscopy, which provides endoscopic examination of the bladder, are other diagnostic methods that can be used when there are various problems related to urinary incontinence.
Treatment of Urinary Incontinence in Women
Urinary incontinence in women It can be treated with surgical and non-surgical methods. Since urinary incontinence is a functional disorder, it must be well managed in order to obtain positive results in its treatment. First of all, the cause of urinary incontinence and what type it is should be determined and treatment should be started accordingly. While drug therapy is generally used in the treatment of urge urinary incontinence, surgery is used in stress urinary incontinence. The surgical procedure to be performed must be performed by physicians who are experts in the field.
Treatment Methods for Urinary Incontinence in Women
Urinary incontinence in women Treatment methods are basically divided into three groups: behavioral, drug therapy and surgery.
Simple lifestyle changes such as weight loss and restricting fluid intake at night are recommended in behavioral therapy for obese individuals. In a behavioral therapy method called bladder training, the patient is asked to urinate only at certain time intervals and empty the bladder as much as possible. Therefore, its purpose is to control the urination reflex. Training the pelvic floor muscles is another behavioral therapy. A practice called Kegel exercises aims to strengthen the muscles that control urination.
Contraction of the bladder is achieved by nerve cells that secrete a substance called acetylcholine. Therefore, anticholinergic drugs treat urge incontinence by blocking this substance, reducing urgency and increasing bladder capacity. In the treatment of stress urinary incontinence, antidepressants are preferred to prevent urinary incontinence by narrowing the urinary tract.
Application of Botox to the bladder muscles is included in surgical procedures. It is especially useful in stopping muscle activity in case of overactive bladder.
In addition to surgical procedures, surgical procedures can be used in the treatment of urinary incontinence when necessary.. Sling surgeries are one of the most commonly used surgical procedures in the treatment of urinary incontinence. The aim of sling surgeries is to support the bladder neck and urethra, which connects the bladder to the outside of the body, in a way that prevents but does not hinder urine leakage under stress.
Urinary Incontinence Treatment with Robotic Surgery
Urinary Incontinence Surgery in Women
In suitable patients, the sling method is usually applied via the vagina. The aim here is to provide support by correcting the urethral angle that causes urinary incontinence. In patients without significant bladder prolapse, the problem is usually permanently resolved with a 15-20 minute surgery. Patients are usually discharged the next day and the effects of the procedure are seen the next day after the urethral catheter is removed. In patients with mild and moderate complaints, the problem is completely eliminated up to without serious side effects.
