Bladder is the organ known as the urinary bladder or urinary bladder. Contraction and relaxation of the bladder muscles are controlled by both the nerves in that area and the brain. The normal bladder stretches as urine fills into it, and there is no increase in pressure. The muscles at the lower end of the bladder ensure that the mouth of the bladder remains closed. After the bladder, there is a channel called urethra. An anatomical problem in any of these pathways can cause urinary incontinence.
Urinary incontinence is the uncontrollable and involuntary inability to hold urine. While it can occur at any age, it is more common in older ages. Urinary incontinence disrupts a person's life comfort and can lead to sexual, social and psychological problems. Women who have given birth more than once, or after menopause or difficult births, may experience urinary incontinence. Sometimes it can even be seen in women who have never given birth. Patients especially; They leak urine when lifting heavy loads, coughing, sneezing, or laughing hard. Urinary bladder prolapse may also occur due to difficult births.
One in four women complains of problems with the bladder and pelvic floor. "I can't hold my urine!", "I go to the toilet every hour, I know almost every toilet!", "I can't go out on the street because of my fear, I can't go to the neighbor!", "I feel like I'm constantly urinating!", "I go to the toilet frequently at night!", "I have back pain and I have groin pain!” or “I have something down there!”.
One in every three women has problems with their bladder after giving birth, and very few of them can completely return to normal. Patients change their lifestyles and limit their social lives. Drinking less water can lead to kidney stones, urinary tract infections and depression. These people are seriously restricted in their sexual lives due to reasons such as embarrassment, loss of self-confidence and fear of their partners noticing their problems. Expressing these problems is seen as a "taboo" and very few patients seek help. They are embarrassed to tell their complaints to the doctor or their relatives, and they think that these problems are normal at their age.
What are the types of urinary incontinence?
- Stress incontinence: Pressure on the bladder caused by laughing, sneezing, coughing, lifting heavy objects It is the type of urinary incontinence that occurs when the n increases.
- Urge incontinence: Here the patient suddenly has difficulty urinating and leaks urine uncontrollably. There is uncontrolled contraction of the bladder.
- Mixed type incontinence: Both types of urinary incontinence are present at the same time.
How is urinary incontinence diagnosed?
A detailed history is taken from the patient who complains of urinary incontinence. The situations that trigger urinary incontinence, the form and frequency of incontinence are learned. Questions such as "Do you leak urine while coughing, sneezing or laughing? Do you ever miss the chance to go to the toilet and leak urine at the toilet door? Is your urinary incontinence accompanied by burning sensation or frequent urination? How long have you had urinary incontinence and how did it start?" asked the doctor. You will be asked to understand the cause of urinary incontinence and determine its type. To the patient; blood sugar, urinalysis and urine culture, ultrasound and urodynamics may be requested.
What are the causes of urinary incontinence?
Obesity, advancing age, bladder sagging, genetics, constipation, cystitis, vaginal infections, urinary tract or kidney stones, diabetes, menopause, difficult births, some medications, dementia, Alzheimer's disease.
How is urinary incontinence treated?
The priority is treatment based on the cause. If the patient is overweight, he can lose weight with an appropriate diet and exercise program. If the cause is constipation, the diet is regulated, a fiber-rich diet is recommended, and medication is given. In case of uncontrolled diabetes, the patient's medications and diet are regulated. Excessive fluid intake is prevented. Patients who use excessive cigarettes and alcohol are asked to reduce them. Urinary tract infections are treated with appropriate antibiotics. Bladder and pelvic muscle strengthening exercises are recommended. There are also drug treatments used in cases of urinary incontinence. These are given to suitable patients by physicians. If urinary incontinence is caused by an anatomical condition such as bladder prolapse or impaired bladder neck angle, surgery may be considered.
How can I be treated?
Kegel exercises should be tried first in patients with stress incontinence. Surgery has a success rate of 75-90% for patients who do not benefit from exercises. options should be offered. Most of these surgeries are short surgeries lasting 15-30 minutes that can be easily performed by a specialist urogynecologist. The patient can go home on the same day. Patients with overactive bladder disease should never undergo surgery. These patients should be given medication. Apart from these two basic problems, there are also patients with neurological or diabetic problems. Such patients should be treated with a multidisciplinary approach. In these cases, treatment should be planned by consulting internal medicine and neurology physicians.
Do I need treatment?
Your physician should evaluate you and decide whether you need treatment. However, if you think that your urinary incontinence problem seriously affects your life and has negative effects on you socially and psychologically, you should express this clearly to your doctor and seek help.
Do not let urinary incontinence be your fate!
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