Urinary incontinence is a health problem frequently encountered by obstetricians.
Definition: It is involuntary urinary incontinence or incontinence, which we call as Urinary Incontinence.
It is a problem that can be seen at any age, although it is common in middle-aged and older women.
Sudden and involuntary urinary incontinence or incontinence.
Under normal conditions, when the bladder is full, people should be able to urinate wherever and whenever they want.
It should not be regarded as a normal situation brought about by normal birth or advanced age.
Although it is difficult to voice such complaints, they must be said.
Treatment is possible and should not be neglected.
It is a hygienic problem that negatively affects the quality of life.
It also affects social life and business life.
These patients cannot go out of the house or look for the toilet everywhere they go, this creates serious unhappiness and lack of self-confidence in them and may cause depression after a while.
These women even hesitate to drink water, but not drinking water does not solve this problem.
Although the pregnancy process is the most important risk factor, the risk increases even more with normal vaginal delivery.
Multiple births, difficult deliveries, and giving birth to large babies can damage the pelvic tissues.
Every normal vaginal delivery woman does not leak urine.
Obesity is also a common cause, because obese women who have not given birth can also experience urinary incontinence. Rapid weight loss also poses risks.
Chronic diseases such as hypertension, diabetes, asthma-cough and constipation and the drugs used for these can cause it.
With the decrease in estrogen hormone in advanced ages and menopause, these tissues may loosen.
Tumors in this area, smoking and surgical procedures around the urinary tract can be counted among the causes.
Sometimes urinary tract infections and kidney stones can also cause or increase in severity.
There are different types of urinary incontinence and their treatments are also different. Stress, compression and mixed type are common.
The first is the urinary incontinence that develops as a result of increased intra-abdominal pressure during laughing, coughing, sneezing, climbing stairs and lifting heavy things, which we call the more common type of stress. It occurs at relatively younger ages.
The second is the urge type, which we call the overactive bladder, in the form of incontinence when suddenly urinating at rest and going to the toilet.
Involuntary and sudden contractions occur spontaneously in the bladder.
These contractions do not normally occur even when the bladder is full.
Third, the condition where both types are seen together is defined as mixed urinary incontinence.
Apart from these, there are other types such as continuous urinary incontinence, overflow type urinary incontinence.
It is possible to determine the type of urinary incontinence and plan treatment by listening to the patient’s complaints and a detailed physical examination.
Regardless of the amount of urine escaping, this is a urinary incontinence problem.
It should be investigated whether there is an additional health problem that causes this situation.
Treatment: Kegel, behavioral therapy, medical, surgical
Treatment depends on the type of urinary incontinence.
Regardless of the type, we recommend Pelvic floor exercises, which we call Kegel exercises, first.
These exercises increase the ability to hold urine.
It also prevents sagging of organs in the genital area.
They are easy exercises to do and should be done with patience because they give results in 3-6 months.
It is enough to set aside 10-15 minutes every day.
Simply put, interrupting while urinating. It can be done by contracting and relaxing the muscles that hold urine.
After the target muscle is learned in this way, the same exercise should be repeated throughout the day.
It will be sufficient to do 30 times 10-second squeezing exercises 3 times a day in the morning, noon and evening.
Urinary behavior therapy can be added to these treatments.
Tea, coffee and smoking habits should be reduced if possible.
Urine should be urinated at certain intervals, and urine should be tried to be retained at certain times.
Trying to go to the toilet in sudden urgency may cause urine to escape, so waiting 20 seconds by squeezing the pelvic floor muscles at that moment can prevent urine leakage.
Medications are usually effective in urge urinary incontinence.
There is a functional disorder in the bladder, that is, involuntary contractions and can only be reduced with drugs.
These are conditions that require long-term drug use.
The drugs used may have some side effects, but they will decrease as the treatment continues.
Surgical treatment is mostly applied in cases of stress urinary incontinence.
Because in this type of urinary incontinence, there is an anatomical, that is, a structural deterioration.
This is attempted to be corrected surgically.
It is a not very big operation technique.
There are different techniques that can be done abdominally or vaginally, such as a cesarean section.
Mostly, a technique is used, which is applied by placing a patch-mesh, which we call mesh, under the canal that allows the urine to be discharged from the urinary bladder through the vaginal route.
Again, with some injections made around this canal, it may be possible to support and treat the tissues there.
In this operation performed with local or spinal anesthesia, the patient can be discharged on the same day.
I ask our patients to convey even the slightest complaints about this situation to their physicians.
Urinary incontinence is not normal.
I wish you a healthy and happy life.