Kidneys, urinary tract and bladder form the basic parts of the excretory system. The main function of the kidneys is to clean the blood. About 200 liters of fluid pass through the kidneys per day.
What is Urinary Incontinence?
The main function of the bladder is to store urine. It continues to work under the control of the brain and spinal cord that make up the central nervous system.
The word continence refers to the ability to urinate voluntarily when urine retention occurs in the appropriate place and time within the framework of social rules. Incontinence is the loss of control of this voluntary urination ability for various reasons. Today, all kinds of urinary incontinence are included in the definition of incontinence.
Urinary incontinence is more common in women. Although it is not a life-threatening situation, personal hygiene, psychological integrity, daily activities and sexual life are adversely affected by urinary incontinence.
What are the Types and Symptoms of Urinary Incontinence?
Persistent urinary incontinence covers many subgroups such as stress type, urge type, mixed type, nocturnal enuresis (incontinence during sleep), functional type, overflow type.
- Stress incontinence: Coughing Urge incontinence: It refers to the involuntary leakage of urine that occurs following sudden urge to urinate. It is the most common type of urinary incontinence in elderly patients.
- Mixed type incontinence: It is the type of urinary incontinence in which stress and urge incontinence are seen together. Although rare, combinations of other types can coexist.
- Nocturnal enuresis: It is the type of incontinence that expresses the incontinence of urine at night after falling asleep without being aware of it.
- Overflow urinary incontinence: Due to excessive stretching of the bladder arises. Frequent or continuous leakage and dripping is the main symptom of urinary incontinence.
- Functional incontinence: It is urinary incontinence that occurs as a result of patients not reaching the toilet on time, although there is no problem in the urinary tract or bladder. Caused by physical or cognitive limitations �Kar.
Temporary urinary incontinence may occur due to drugs such as alcohol, caffeine, carbonated - acidic drinks, artificial sweeteners, bitter and spicy foods, tranquilizers and muscle relaxants.
Urinary Incontinence (Urinary Incontinence) What are the Risk Factors?
Age
The muscles that form the pelvic floor and prevent urinary incontinence by contraction weaken with age. Urinary incontinence may occur with this weakness in the lower abdomen. Studies have shown that urge urinary incontinence increases after the age of 54, and the risk of stress urinary incontinence starts from the age of 35. Urinary incontinence may occur as a result of damage to the sphincter (annular musculature). The birth weight of the baby, the weight gained during pregnancy and how the birth took place are among the important risk factors for urinary incontinence. Urinary incontinence may occur in invasive deliveries and after pregnancies with a high birth weight of the baby.
Obesity
Weight gain damages the muscles lining the pelvic floor. A body mass index above 30 increases the risk of urinary incontinence. Improvement of incontinence after weight loss can be seen only in people with urinary incontinence complaints due to this reason. This increase in pressure can prevent the nerves and muscles that control bladder activity from being fed with blood circulation, leading to urinary incontinence.
What Problems (Complications) Occur After Incontinence?
Continuous wetness of the overlying skin causes redness and rashes. At the same time, recurrent urinary tract infections, as it will be easier for bacteria to grow in the missed urine. infections can be seen.
The emergence of problems related to daily activities and work life with urinary incontinence adversely affects the quality of life of the person.
What are the Diagnostic Methods for Urinary Incontinence?
Diagnosis of urinary incontinence begins with the patient's history. Evaluation of the type of urinary incontinence is made by examining when the symptoms started, how much incontinence is, and what the increasing and decreasing factors are. Evaluation of neurological diseases and anatomical abnormalities that may be the cause of urinary incontinence, together with the physical examination performed by the doctor, has an important place in the diagnosis stage. It is useful to evaluate whether abduction has occurred. One of the methods used for diagnosis is the voiding diary. The conditions and frequency of urinary incontinence are recorded on a chart.
Urine analysis and biochemical analyzes are laboratory analyzes that provide information about the presence of infection and the capacity of the kidneys.
Ultrasoundography (USG) imaging in the bladder and urinary tract The presence of obstructive conditions such as tumors and stones is examined. USG is also used in a test called PVR (post voiding residue), which is done within a few minutes after the person has voided their urine. The PVR test measures how much urine remains in the bladder after urinating. What are the Treatment Methods for Urinary Incontinence?
Treatment of urinary incontinence is basically divided into 3 categories as behavioral, pharmacological (drug therapy) and surgical. Simple lifestyle changes, such as limiting dietary intake, are recommended. In the behavioral treatment method called bladder training, the person only urinates at certain time intervals. Ask him to empty his bladder as much as possible. Thus, it is aimed to control the voiding reflexes. Training the pelvic floor muscles is another behavioral treatment method. With the applications called Kegel exercises, it is aimed to strengthen the muscles that control the urine.
- Contraction of the bladder occurs by the secretion of a substance known as acetylcholine from the nerve cells. For this reason, anticholinergic drugs are used in the treatment of urge urinary incontinence by blocking this substance, reducing urgency and increasing bladder capacity. In the treatment of stress-type urinary incontinence, antidepressants that prevent urinary incontinence by contracting the urinary tract are preferred.
- The application of botulinum toxin (botox) to the bladder muscles is one of the surgical applications. It is beneficial by stopping muscle activity, especially in cases where the bladder is overactive.
- In addition to surgical applications, surgical operations can also be used in the treatment of urinary incontinence when necessary. Suspension surgery is one of the surgical interventions applied in the treatment of urinary incontinence. The purpose of sling operations is to support the bladder neck and the urinary tract urethra, which connects the bladder to the outside of the body, in a way that will prevent urine from escaping during stress but not cause any obstruction.
Read: 0
