Urinary incontinence in women;
Urinary incontinence complaints, seen in approximately 20% of all women, occur in 20-25% of premenopausal women and in menopausal women. It increases to 40-60%. And it creates social, hygienic, emotional, economic and sexual problems in women.
Types ;
Many types of urinary incontinence. And although there are reasons, there are two most common reasons. The most common of these is what we call Stress Incontinence, which is urinary incontinence when women sneeze, cough, strain or laugh, when the intra-abdominal pressure increases, and Urge (urgent) incontinence is the sudden feeling of urination and urinary incontinence due to not being able to reach the toilet. These two conditions can occur separately or together and constitute approximately 85-90% of all urinary incontinence.
Patients mostly;
< br /> -Coughing
-Laughing
-Jumping
-Climbing stairs
-He leaks urine when he acts like straining
Urge (urgent) In incontinence; Even if patients do not take any action, they have a sudden urge to stop their work and urinate and experience urinary incontinence while trying to reach the toilet.
These two conditions should not be confused with each other. Apart from these situations, urinary incontinence may also occur in diabetes or some neurological diseases, genital fistulas, excessive constipation, urinary tract infections or during the use of drugs that increase urine flow. It is necessary to have a urogynecological examination to distinguish these conditions from each other.
When should you go to the doctor?
-Urinary incontinence complaint.
-If there is a complaint of fecal incontinence
-If there is frequent urination (more than 8-10 times a day)
-If there is a feeling of not being able to void urine completely
-If there is discomfort in sexual intercourse
-If there is vaginal burning, pain, itching, discharge
Which situations increase the tendency?
-Advanced age and women gender
-Those with a family history of urinary incontinence
-Menopause
-Previous pelvic surgery history
-Diabetes, heart, kidney, joint and spinal cord diseases, previous stroke&nb sp;
-Smoking and chronic cough that develops due to it
-Excessive consumption of alcohol, tea and coffee
-Weight gain, chronic constipation, cough
Are there any simple tests that patients can do on their own?
Women can do the Pad Test on themselves, which we do for our patients. The patient should first drink 500cc of liquid, and after 20 minutes, put a previously weighed pad into the vagina. /> -Climbing stairs for 1 minute
-Bending down 5 times and picking up something from the floor
-Coughing 12 times
-After doing exercises such as running for 1 minute, the pad should be weighed and if there is a weight increase of 10 grams or more, a doctor should be consulted. .
How do we know?
-Does it affect the ability to do small housework?
-Walking, swimming, Does it affect doing physical activities such as exercise?
-To what extent does it affect participating in recreational activities such as movies, concerts, weddings, etc.?
-Does it affect traveling for more than 30 minutes by car or bus?
-Does it affect participation in social activities outside the home?
-Does it affect your mental health (nervousness, depression, anxiety, etc.),
-Does it create a feeling of frustration?
What should be done to protect yourself?
-One should go to the toilet every 3-4 hours. Urination and defecation should not be delayed and should not be forced. - Diseases that cause urinary and stool problems should be treated without delay. - Pelvic floor muscle exercises should be applied throughout life. should be followed closely after birth, challenging births should be avoided.
-Menopause checks should not be interrupted, estrogen should be taken if necessary
-Especially inactivity due to aging, chronic cough, chronic constipation, mental problems and inactive patients with hip fractures should be closely monitored
Do you have any recommendations for proper nutrition?
Nutrition and lifestyle regulation are very supportive of patients with stress incontinence. In this case, women at risk;
-Avoid excess weight. �, overweight women should be as close to their normal weight as possible
-6-8 glasses of water should be drunk a day, fluid restriction should be avoided
-Cola, coffee, strong tea, especially acidic fruit juices (the most important ones are orange, grapefruit juice) and spicy foods are irritating to the urinary tract. You should not overdo it when eating these foods. - Constipation should be avoided; for this, pulp, green leafy and fibrous foods should be consumed (in the morning, on an empty stomach, drink a glass of water over a few dried apricots, dried figs, prunes).
- It increases urination. Medicines and foods should be avoided, especially late in the evening.
Treatment;
First of all, the type and cause of urinary incontinence should be determined. From now on, we make a number of treatment recommendations to the patient depending on his/her condition, from life behavior recommendations to pelvic muscle exercises or from medical treatment to surgical treatment.
New developments in treatment;
First of all, although some patients suffer from these problems, they cannot consult a doctor because they are embarrassed and bored, and a group of patients accept this situation as a fate of women since it is common in society. Another problem is the general concern in patients who have been operated on using old methods that the surgeries they hear about do not work. Another troubling situation is that patients who require pelvic exercises and physical therapy either do not comply with these treatments or cannot reach the physicians and institutions that can perform these treatments because they are limited.
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