Working of the Urinary Bladder:
The urine formed as a result of the kidneys filtering the blood reaches the urinary bladder by traveling through the urinary
ways to be excreted from the body. The function of the urinary bladder
is to store the urine coming from the kidneys at low pressure until it is emptied at a socially appropriate time and place
. The storage of urine in the urinary bladder and its discharge at regular intervals is a chain of events that repeats itself. A normal adult can accumulate approximately half a liter of urine in the bladder at low pressure. Meanwhile, the muscle group called sphincter, located at the exit part of the bladder, prevents urine leakage by keeping the bladder outlet closed. During the evacuation of urine, on the one hand, the urinary bladder contracts, and on the other hand, the sphincter relaxes, opening the mouth of the bladder and making it possible to expel the urine. Urinary bladder or sphincter disorders may cause urinary incontinence.
Urinary Incontinence Forms:
Urinary incontinence can basically be divided into 3 types. During the storage of urine, involuntary contractions that occur in the bladder wall for various reasons usually cause urinary incontinence, which causes compression and inability to reach the toilet. In this way
urinary incontinence is called "Urge Urinary Incontinence". It is called. On the other hand, as a result of the weakening of the sphincter mechanism, movements that increase intra-abdominal pressure, such as coughing and sneezing, cause urine leakage. This type of urinary incontinence is called Stress Urinary Incontinence. Another form of urinary incontinence is the inability to empty the bladder due to diseases that obstruct the exit of the bladder, such as prostate enlargement
, or the weakening of the bladder and its inability to contract. It is incontinence, which occurs as a result of the amount of urine exceeding the capacity of the bladder
and urine overflowing drop by drop
. This is called "Overflow Urinary Incontinence". It is called
. In a patient with urinary incontinence, any of these 3 forms of urinary incontinence may occur alone or in more than one form. may occur together.
Urinary Incontinence Treatment:
When deciding on the treatment of urinary incontinence, it is important to reveal the type of urinary incontinence and the underlying
reasons. While it is important to prevent uncontrolled contractions in the urinary bladder in the treatment of Urge-Type incontinence, it is important to strengthen the sphincter mechanism in Stress-Type incontinence. Overflow
The treatment of overflow type incontinence is to prevent urine from accumulating in the bladder
that is, to ensure proper drainage of urine. These
treatments can be done in the form of medication or surgery. Behavioral treatments applied before or simultaneously with drug or surgical treatment,
appropriate regulation of daily fluid intake in terms of amount and time, review of toilet habits
and Similar lifestyle changes should not be neglected
. In addition, it is important to perform movements called pelvic floor or Kegel exercises in order to strengthen the sphincter in the majority of patients
and is the first step treatment method in some patients.
Urination in Patients How to Determine the Type of Incontinence:
Since the treatment of urinary incontinence will vary depending on the type of urinary incontinence, it is very important to determine the type of urinary incontinence in each patient in order to determine the correct
treatment
. In the majority of patients, the patient's complaints, physical examination
findings, bladder diary, laboratory tests, urine flow rate and some tests such as measuring the amount of urine remaining in the bladder after urination and pad test
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The type of urinary incontinence can be determined. However, there are some patients who have not benefited from the previous treatment, whose complaints are not compatible with the examination and test results, who are planned to undergo surgical
treatment, and some who have urinary incontinence due to neurological problems
Further examinations may be required to accurately determine the form of urinary incontinence in patient groups such as patients. The most important of these examinations is the urodynamic study, which examines the observations made while the bladder is filled and emptied and the pressure changes that occur. Urodynamic study
It is done in the urodynamics laboratory. Urodynamic study provides very important information in determining the type of treatment to be applied for some patients
and in evaluating the responses of some patients to treatment
. In addition to urodynamic
study, imaging of the urinary tract and urinary
bladder can be performed with various radiological methods, and endoscopic examination of the urinary tract and
sphincter with a camera can be performed using a method called cystoscopy. It is among the other
examinations.
Final Words:
Urinary incontinence is a condition that can be seen in both men and women and its incidence increases with age
is the problem. If people suffering from urinary incontinence consult a physician, it is possible to first perform the necessary tests to determine the type of urinary incontinence and then provide appropriate treatment.
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