Urinary incontinence is a social problem that affects a large proportion of women but which they have difficulty expressing. What are the causes of urinary incontinence in women? How is it treated? Acıbadem University Atakent Hospital Gynecology and Obstetrics Specialist Dr. Elif Ganime Aygün explained urinary incontinence in women.
What is urinary incontinence in women?
Urinary incontinence is the involuntary leakage of urine during exertion, i.e. coughing, sneezing or when there is a feeling of tightness. Urinary incontinence is a social problem that affects a large proportion of women but they have difficulty expressing it. As I mentioned in the first sentence, it can occur in two forms and rarely there may be combined incontinence. It is a social problem that requires treatment under all circumstances.
What are the symptoms of urinary incontinence in women?
Symptoms can be in two ways; it can be incontinence with straining, laughing, coughing or sneezing, or sometimes the patient may have symptoms such as spontaneous urinary incontinence while going to the toilet. In both cases, urinary incontinence is out of the patient’s control. Incontinence with exertion is called stress type incontinence, while incontinence with urinary compression is called urge (overflow) type incontinence. If both incontinence are together, it is called mixed type incontinence.
What causes urinary incontinence in women?
The cause will vary depending on the type of incontinence, but basically it is caused by a pelvic floor defect. Surgical or birth trauma to the pelvic muscles and neurological disorders of the bladder are among the causes. Problems such as diabetes and hypertension are also among the causes. Although normal delivery is generally supported by obstetricians, it will damage the pelvic floor muscles in an untrained patient under any circumstances. A patient who receives pelvic floor exercises for normal delivery as of the 20th week of pregnancy can give birth without damaging the pelvic floor muscles or even without an incision (episiotomy). In patients undergoing gynecologic, urologic or gastroenterologic oncologic surgery, the pelvic floor may also be damaged during surgery and this patient group may also experience urinary incontinence after surgery.
What are the problems caused by urinary incontinence in women?
Incontinence in itself affects private and social life, disrupts comfort and restricts movement in the patient. Patients with urinary incontinence cannot continue their daily life and sexual life. He always goes to places close to the toilet. He carries a urine pad with him. He is worried about odor. He experiences loss of comfort in his private life with his partner. Urinary incontinence may be more intense during intercourse and this causes anxiety disorder in the patient.
What are the types of urinary incontinence in women?
Stress type incontinence is incontinence caused by exertion. Overflow type urge incontinence is the incontinence that occurs when you get stuck. In stress type incontinence, the patient leaks urine every time she laughs, coughs and sneezes. This incontinence may be in the form of drops or the entire bladder may empty. In overflow type incontinence, the patient feels urine and passes urine while going to the toilet. Such patients may also leak urine when they hear the sound of water or see a running faucet.
How is urinary incontinence diagnosed in women?
The diagnosis is made by physical examination and urodynamic tests. During physical examination, the patient is subjected to tests that require effort and tests we call q-type. In stress type incontinence, incontinence is already observed during physical examination. In overflow incontinence, there is no incontinence in these tests, but the patient already summarizes the situation very clearly in his/her history. In these patients, urodynamic tests are more diagnostic.
What is the treatment of urinary incontinence in women?
In some patients, surgical treatment is performed, while in others medical treatment and sometimes laser is applied. There are also patients in whom treatments are combined. In general, even if we look at the case on the basis of pelvic floor health and say surgical or medical treatment in rehabilitation and treatment, we should also receive pelvic floor health physiotherapy support. In surgery, a synthetic sling is placed on the bladder neck. This sling is not felt by the patient because it is under the mucosa of the vagina. Adding pelvic physiotherapy to medical treatment with laser in overflow incontinence improves the patient’s quality of life immensely. Incontinence is more common especially in the menopausal period. Local estrogen therapies will increase the effect of treatment in appropriate patients.
Things to consider after urinary incontinence surgery
After surgery, the patient should definitely go to the toilet before the urine is too full and empty the urine with correct breathing exercises. Urinating by taking a step under the feet will relax the pelvic muscles. In our clinic, we support each patient after surgery in the pelvic floor health center and prepare the bladder for its new position with bladder gymnastics in the first 24 hours. it is important to prepare. We definitely give local estrogen therapy to the appropriate patient. Urinary incontinence should be considered complex and managed multidisciplinarily. Otherwise, it is very difficult to achieve cure in treatment. Patients should be supported with pelvic floor training and exercises.
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