Urinary Incontinence in Women

Urinary incontinence in women is about 2 times more common than in men. Although this complaint is not a life-threatening condition, it seriously impairs the quality of life. Think about it; You climb 3 flights of stairs and squeeze your abdominal muscles so hard to hold back urine that you feel muscle pain; coughing and sneezing become an event that should not be done in public after a while; You go shopping. You have to go to the toilet 3 times in 1 hour… Many stories like these.

As the elderly female population increases, urinary incontinence is a serious problem. It is a problem that affects almost 50% of women. However, 2/3 of these women do not seek a solution mainly because of social shyness or because they are unaware that they can get help in this regard.

What are the causes and risk factors of urinary incontinence?

• Advancing Age: When menopause occurs and age progresses and the estrogen hormone decreases, the supporting tissues in the pelvis that hold the bladder and uterus in place weaken and urinary incontinence increases.

• Birth: Reasons such as a large number of births, large babies, and the use of vacuum during delivery are often present in women with urinary incontinence.

• Being Overweight, Obesity: Intra-abdominal pressure increases and urinary incontinence is more common in overweight people.

• Hereditary Causes: Some women’s supporting tissues and ligaments are weak from birth and they are prone to urinary incontinence.

• Constipation: Straining weakens the supporting tissues.

• Smoking: Urinary incontinence is more common in smokers.

• Chronic Diseases: Asthma, bronchitis, diabetes, muscle diseases and accidental trauma to the spine are risk factors.

Today, it is possible to treat urinary incontinence with medication and surgical methods. The type of treatment depends on the type of urinary incontinence. There are basically 3 types of hijacking:

  1. Stress incontinence: Urinary incontinence when coughing, sneezing or lifting heavy.

  2. URGE incontinence: Urinary incontinence with an urgent need to void.

  3. Mixed incontinence: A combination of both.

  1. Stress Incontinence: Involuntary leakage of urine with exertion or physical exertion, sneezing or coughing. In cases that increase intra-abdominal pressure, urinary incontinence occurs when this increased pressure is not transmitted to the urethra properly.

Reasons:

-obesity

– previous pregnancy and difficult birth history

– previous surgical operations

Patients are asked to come with a full bladder, if possible, for examination. It is tested whether the patient is leaking urine by coughing and straining. Afterwards, a gynecological examination is performed on the patient and it is checked whether there is sagging in the bladder, vagina and adjacent organs. Meanwhile, the patient’s pelvic floor muscles, which provide urine retention, are also evaluated.

Non-surgical methods of treatment:

Dietary measures may be the modifiable factor. Reducing the consumption of caffeinated and alcoholic beverages, fluid restriction in patients who will not have any health-related problems, pelvic floor muscle exercises, weight loss in patients with overweight problems, teaching and applying KEGEL exercises can improve patients with mild to moderate urinary incontinence.

Surgical treatment should be considered in patients with severe urinary incontinence or those who are unsuccessful in these methods. There are many surgical methods defined on this subject. Which method is suitable for the patient is determined by the doctor as a result of examination and a number of tests, and improvements are reported after a properly selected surgical procedure. In many of the most commonly used surgical methods, the quality of life of the patient increases significantly.

  1. URGE Incontinence: It is the complaint of involuntary urinary incontinence with urgent urgency. The patient may have complaints of frequent urination and nocturnal urinary incontinence. It is a condition that occurs in almost 38% of women older than 65 years.

Behavioral changes and medication are standard treatment for this type of urinary incontinence.

Behavioral therapy; It is the creation of a schedule of urination for the patient at certain intervals, timed urination, a kind of retraining of the bladder. Pelvic floor exercises are also helpful in the treatment of this type of urinary incontinence.

  1. Mixed Incontinence: It is the type in which both stress and urge urinary incontinence are seen together. Patients may show symptoms of both types. Treatment should be planned according to the patient’s worst symptom. Whichever symptom affects the patient’s life more, the treatment of that symptom should be given priority. In patients with mixed urinary incontinence, surgical treatment + drug treatment can be applied together. The results in patients treated in this way are quite promising.

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