CAUSES AND RISK FACTORS OF URINARY INCONTINENCE
Advancing Age: Estrogen decreases with menopause. The tissues that hold the bladder (urinary bladder) in place begin to weaken.
BIRTH: The formation of birth tears resulting from the birth of a large baby and the increasing number of births increase the risk of incontinence.
OBESITY: Excess weight and fat in the abdominal area increase intra-abdominal pressure. and may cause urinary incontinence more frequently.
CONSTITUTION: Continuous straining weakens the support tissues
Smoking
CHRONIC DISEASES: Asthma, chronic bronchitis, diabetes, muscle diseases,
Previous gynecological diseases
/> Frequently recurring urinary tract infections
Some medications
URINARY INCONTINENCE TYPES:
1- STRESS TYPE INCONTINENCE: In case of increased intra-abdominal pressure (while laughing, sneezing, walking). It is involuntary urinary leakage that occurs when coughing, coughing and exercise. It is the most common type (50% -70%). The most common cause is the weakness of the pelvic floor muscles.
2- URGE INCONTINENCE (URGE TYPE): It is also known as detrusol instability. It is the involuntary contraction of the bladder due to bladder filling or other stimuli. It is the second most common type (30%). When you feel the need to go to the toilet, urinary incontinence occurs before you can reach it. The main reason is that the bladder muscles are overactive and sensitive.
3- MIXED TYPE INCONTINENCE: It is the type where stress and urgency type are seen together. It is seen in 20%.
4- OVERFLOW TYPE INCONTINENCE: It is also known as overflow incontinence. When urine accumulates in the bladder beyond its capacity, urinary incontinence occurs in the form of drops. It is seen in 5-10%.
5- SPHINCTER DEFICIENCY: It is very rare. It can be observed in urinary tract injuries.
HOW IS THE DIAGNOSIS MADE?
A detailed anamnesis and physical examination reveal incontinence. It provides very important information in determining the type and treatment, and urine culture, post-mictural residue measurement, urodynamic examinations and trans-vaginal ultrasonography are also among the tests and evaluations used in diagnosis.
URINARY INCONOUS TREATMENT
Conservative Treatment
-Kegel Exercises: To strengthen the pelvic floor muscles in stress incontinence. �recommended.
-Biofeedback Treatment: Bladder training is performed by recording the physiological functions of the pelvic floor muscles with urge and stress incontinence type electromyogram electrodes. It is aimed to increase the bladder capacity in a controlled manner.
-Magnetic Application:. It is aimed to strengthen the pelvic floor muscles by stimulating the pelvic floor muscles and nerves with magnetic waves.
Medical Treatment It is frequently applied in stress and urge incontinence. For this purpose, systemic or local estrogen application and some anticholinergic drugs are mostly used.
Surgical Treatment Surgical treatment is applied for urinary incontinence due to stress incontinence and sphincter insufficiency. Success rates can reach up to 80-90% with new surgical treatment procedures. The bladder neck can be suspended by performing the abdominal Marchall Marchet-ti Kranz and Burch procedure. Incontinence can be prevented by suspending the bladder, bladder neck and paraurethral areas vaginally with Cystocele, IVS-Sling, TVT and TOT procedures.
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