Urinary incontinence in women!

One out of every three women suffers from urinary incontinence after puberty. This is sometimes temporary, but most of the time it is permanent. Urinary incontinence is one of the most common conditions, especially due to sagging of the bladder. When the bladder slides down from where it should be due to the structurally relaxed muscles of women due to pregnancy, constipation, frequent coughing, heavy lifting and some hormonal reasons, urinary retention mechanisms become inoperative and urinary incontinence occurs. Today, with a simple 20-30 minute surgical technique, urinary incontinence due to bladder prolapse can be prevented so that the patient can stand up immediately without a stab wound from the outside.

How Do We Urinate?

The bladder normally resembles a balloon that can hold up to 500 mL of urine. When it reaches this volume, it sends a signal to the brain and tells it to empty. Our brain controls our bladder with electrical signals that enable us to hold more or start urination according to the environment we are in. A full bladder has a valve mechanism that prevents urinary incontinence. This mechanism is turned off before the urination order comes. After the command of our brain to urinate, the muscles of our bladder begin to contract and the urinary retention mechanism in the front opens, and the urination function takes place.

How do we hold our urine?

There are 3 basic points necessary for urinary retention in women. The first is the amount of urine that the bladder can hold, namely its capacity. The bladder is an organ that is sensitive to tension. As it fills, the muscles relax more and try not to increase the pressure in the bladder above a certain level. In cases where the amount of urine that the bladder perceives or can actually take in decreases, people may experience a feeling of urgency, the need to urinate frequently, and even involuntary incontinence. The second important point is the position of the bladder in the uterus. If the bladder protrudes downwards, the functioning of the urinary retention mechanisms is impaired. In this case, urinary incontinence occurs in situations such as coughing, sneezing, heavy lifting, meridine exiting, straining in constipation, where the pressure in the abdomen and therefore the pressure towards the bladder increases. Another point is the strength of the muscles that operate the urinary retention mechanism. If there is a looseness in these muscles, then involuntary urinary incontinence may occur again.

Characteristics of Normal Bladder:

It takes about ½ liter of urine in it.

Before this fullness is reached, the feeling of fullness begins.

Needs to urinate 4-7 times a day on average

Wakes you up to urinate once a night

Does not leak urine without your control

Completely ejaculate after urination

Allows you to hold back for a certain period of time after the feeling of urination occurs.

When Should You Go to the Doctor?

If you cannot perform the items listed above as the characteristics of the bladder, you should consult a doctor. The following questions also reveal your need for medical treatment:

Do you leak urine when you laugh, cough or sneeze?

Do you suddenly need to go to the toilet?

Do you feel the need to use diapers or pads for urine control?

Do you think that there will be a toilet problem when you go somewhere and you have to make your plans accordingly?

Do you have urinary incontinence in your daily work or when you get up in the morning?

What awaits you when you go to the doctor?

The most important point that your doctor should do for you is to determine the type of your urinary problem. The success rate in terms of urinary incontinence is very high after treatment with correct diagnosis. For this, your doctor will ask you detailed questions about your abduction. Later, during the examination, the sagging condition of your bladder, the cervix, the strength of the tissues and how much your bladder droops during procedures such as coughing will be checked. Generally, the second step is to look at how much urine is left in the bladder after voiding with ultrasonography. It will also be analyzed whether there is an infection that may cause urination complaints.

After this initial evaluation, a computerized measurement called urodynamics may be requested depending on the condition of the patients’ complaints. You may also be asked to fill out a voiding diary for at least 24 hours at home.

Can Incontinence Be Treated?

Yes… But the first step in treatment is to accept that this is a treatable problem and to consult a doctor. The success rate of patients who apply to a doctor with urinary complaints is high, and people can return to their daily lives and their quality of life increases significantly.

Drug Treatments

Medicines are used in cases where the capacity of the bladder decreases or its sensitivity increases. In this way, the bladder finds its normal capacity and the sudden feeling of urgency to the toilet and subsequent incontinence can be eliminated. Likewise, since various infections in the bladder trigger similar complaints, drug treatments can also be given for them. However, drug treatments are not effective in cases of urinary incontinence due to bladder prolapse.

Surgical methods

Simple, effective surgeries can now be performed successfully in order to ensure that the prolapsed bladder remains where it should be. A support tissue that will solve the problem of urinary incontinence is placed through a 2-3 cm incision made in the vagina without any surgical scars in the abdomen. With these methods called “sling”, that is, sling operations, it is possible to eliminate situations such as the bladder falling down after the pressure in the abdomen increases and the urinary retention mechanisms are impaired. After a 20-30 minute operation, the patient can walk home within 1-2 hours and return to his normal life within a day.

Bladder botox application

In cases where there is no response to drug treatments in overactive bladder or when the use of drugs such as Parkinson’s Disease is problematic, botox applications can be performed into the bladder with a method that does not require 15 minutes of anesthesia in order to control excessive contractions in the bladder and increase bladder capacity. After this treatment, which started to show its effect within 1 week, people can return to their normal lives and serious improvements are felt in urinary incontinence.

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