Urinary incontinence is a health problem frequently encountered by gynecologists.
Definition: Urinary Incontinence is the condition of involuntary urinary leakage or inability to hold urine.
Although it is common in middle-aged and older women, it is a problem that can be seen at any age.
It is the sudden and involuntary loss of urine or incontinence in an unexpected place.
Under normal circumstances, when the bladder is full, people should be able to urinate wherever and whenever they want.
It should not be considered a normal situation brought on by normal birth or advanced age.
Although it is difficult to voice such complaints, they must be said.
Treatment is possible and should not be neglected.
It is a hygienic problem that negatively affects the quality of life.
It also affects social life and business life.
These patients cannot leave the house or look for the toilet everywhere they go, which creates serious unhappiness and lack of self-confidence in them and may cause depression after a while.
These women even hesitate to drink water, but not drinking water does not solve this problem.
Causes:
Although the pregnancy process is the most important risk factor, the risk increases even more with normal vaginal birth.
Multiple births, difficult births and giving birth to large babies. may damage tissues.
Not every woman who has a normal vaginal birth has urinary incontinence.
Obesity is also a common cause because urinary incontinence may also occur in obese women who have not given birth. Rapid weight loss also poses a risk.
It may be caused by chronic diseases such as hypertension, diabetes, asthma-cough and constipation and the medications used for them.
With the decrease in estrogen hormone in advanced ages and menopause, these tissues may become loose.
Tumors in this area, smoking and surgical procedures around the urinary tract can be counted among the causes.
Sometimes urinary tract infections and kidney stones can also cause or increase their severity.
Types:
There are different types of urinary incontinence and their treatments are different. Stress, compression and mixed type are common. .
The first, more common stress type, is urinary incontinence, which develops as a result of increased intra-abdominal pressure during laughing, coughing, sneezing, climbing stairs and lifting heavy objects. It is seen at relatively younger ages.
The second one is the urge type, which we call overactive bladder, which occurs in the form of sudden urination at rest and leakage while going to the toilet.
Spontaneous involuntary and sudden contractions occur in the urinary bladder.
These contractions normally do not occur even when the bladder is full.
Thirdly, the situation where both types occur together is defined as mixed type urinary incontinence.
Apart from these, there are other types such as persistent urinary incontinence and overflow type urinary incontinence.
Diagnosis:
It is possible to determine the type of urinary incontinence and plan treatment by listening to the patient's complaints in detail and detailed physical examination.
Regardless of the amount of urine leaking, this is a urinary incontinence problem.
It should be investigated whether there is an additional health problem causing this condition.
Treatment: Kegel, behavioral therapy, medical, surgical
Treatment varies depending on the type of urinary incontinence.
No matter what type, we first recommend Pelvic floor exercises, which we call Kegel exercises.
These exercises increase the ability to retain urine.
It also prevents the organs in the genital area from sagging.
They are easy exercises to do and should be done with patience because they give results in 3-6 months.
10-15 minutes every day is enough.
Simply defined, interrupting urination while urinating. It can be done by contracting and relaxing the muscles that help hold urine.
After the target muscle is learned in this way, the same exercise should be repeated during the day.
It will be sufficient to do 10 seconds of squeezing exercise 30 times a day, morning, noon and evening.
Voiding behavior therapy can be added to these treatments.
Tea, coffee and cigarette habits should be reduced and stopped if possible.
Urination should be done at certain intervals and efforts should be made to hold urine at certain times.
Sudden s Trying to go to the toilet during an urge may cause urine leakage, so squeezing the pelvic floor muscles and waiting for 20 seconds can prevent urine leakage.
Drugs are generally effective in urge urinary incontinence.
There is a functional disorder in the urinary bladder, that is, involuntary contractions, and it can only be reduced with medications.
These are situations where medication must be used for a long time.
The drugs used may have some side effects, but they will decrease as the treatment continues.
Surgical treatment is mostly applied in cases of stress urinary incontinence.
Because there is an anatomical or structural deterioration in this type of urinary incontinence.
This is attempted to be corrected surgically.
It is a not very large operation technique.
There are different techniques that can be performed abdominally or vaginally, such as cesarean section.
A technique is usually used by placing a patch called mesh under the canal that allows urine to be expelled from the bladder through the vagina.
Again, it may be possible to support and treat the tissues there with some injections made around this canal.
In this operation performed with local or spinal anesthesia, the patient can be discharged on the same day.
I request our patients to convey even the slightest complaints about this situation to their physicians.
Urinary incontinence is not a normal condition.
I wish you a healthy and happy life.
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