1. Clitoris
2. Labium minora (inner lips)
3. Labium majora (outer lips)
4. Vagina
5. Cervix (cervix)
6. Body of the uterus (body of the uterus)
7. Fundus of the uterus (top of the uterus)
8. Urethra (external urinary tract)
9. Anus
10. Rectum
11. Colon (large intestine)
12. Urinary bladder
Urinary incontinence; It can be defined as involuntary leakage of urine.
This hygienic problem, which has a frequency of up to 50% especially in elderly women, appears as an important public health problem for the society.
Before going deeper into the subject. Briefly, it would be useful to take a look at what female continence is like.
First of all, to ensure continence, whether at rest or during a physical procedure, intravesical (inside the bladder) pressure should be used, in no case intraurethral . The pressure (inside the urethra) should not exceed. In other words, for urine to escape, the pressure inside the bladder must exceed the urethral closing pressure.
Structures that provide continence (to retain urine):
1. Intrinsic (internal)sphincteric mechanism
2. Extrinsic (external) sphincteric mechanism
3. Support tissues that ensure that the urethrovesical junction (the point where the bladder meets the urethra) remains in the appropriate position
4. Proper innervation of all these structures (nerve network)
Intrinsic sphincteric mechanism:
Roughly; It consists of the elastic structure of the urethral mucosa and the urethra wall. These structures are estrogen dependent. (In other words, when the woman enters menopause, this structure will not be able to perform its normal function as estrogen will decrease.)
Incontinence
Extrinsic sphincteric mechanism:
Periurethral (around the urethra) sphincter consisting of muscle fibers and muscles belonging to the urogenital diaphragm It occurs.
Incontinence
THE STRUCTURES THAT KEEP THE VESICOSPHINCTERIC UNIT IN ITS NORMAL POSITION
These structures are basically inside the hip, which we call the woman's pelvis. b It consists of structures belonging to the floor muscles of the region (they are condensations of the levator fascia).
All these fascial structures and levator muscle fibers are affected by the increase in intra-abdominal pressure (coughing - straining - going up and down stairs). etc.) contract and pull the urethra towards the symphysis, which is the bone structure in front of it.
Incontinence
Incontinence can be classified in many different ways, but for ease of distinction, the most practical classification is as follows:< br /> TRUE STRESS INCONTINENCE (GSI)
- Urge incontinence
- Neuropathic incontinence
- Congenital incontinence
- Paradoxical or overflow incontinence
- Post-traumatic or iatrogenic incontinence
- Fistulous incontinence
THE MOST FREQUENT FORMS OF INCONTINENCE ARE GSI, URGE INCONTINENCE AND IT IS THE COMBINATION OF TWO CONDITIONS CALLED MIX TYPE.
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