Urinary Incontinence

Urinary incontinence is all kinds of involuntary and uncontrollable urinary incontinence. Urinary incontinence disrupts the life comfort of the person, as well as persistent wetness, irritation and anxiety about bad odor can cause serious social and psychological problems in the person. The incidence of urinary incontinence increases with age and is more common in women than in men.

Types of Urinary Incontinence

  • Stress-induced urinary incontinence: It is the case of urinary incontinence seen during exertion (coughing, sneezing, heavy lifting, exercise, etc.). So why does this occur?

The urinary tract (urethra) is suspended like a hammock by the pelvic structures. The weakening of the structures that support this channel or the damage to the structure we call the sphincter that allows urine retention results in stress type urinary incontinence. Because when the sphincter mechanism is not functioning properly, it cannot be closed completely and urine goes out involuntarily with the increased intra-bladder pressure during effort.

  • Urge-type urinary incontinence: It is a situation of urinary incontinence that occurs with a sudden feeling of urgency that cannot be postponed. Here, there are involuntary contractions in the bladder and there is a problem in storing urine.
  • Mixed urinary incontinence: Both types of urinary incontinence are together.
  • Overflow type urinary incontinence: It is involuntary incontinence of excess urine by filling the

What Causes Urinary Incontinence?

  • Genetic predisposition
  • Weakness of the pelvic floor muscles
  • Neurological diseases
  • Hormone deficiency and menopause
  • Pregnancy and difficult births
  • Urinary tract infection
  • Previous prostate surgeries
  • Previous urological, gynecological and bowel surgeries
  • Prostate enlargement
  • Overactive bladder
  • Radiotherapy
  • Obesity
  • Congenital urological anomalies
  • Doğuştan gelen ürolojik anomaliler

Evaluation and Diagnosis

First of all, a detailed history is taken from the patient and a physical examination is performed. To find out the seriousness of urinary incontinence, a urination diary is filled. Urine analysis, urine culture, urinary ultrasound, waste urine measurement, uroflowmetry, pad test, urodynamic examination and cystoscopy are the examinations applied when necessary.

Treatment

Conservative Approach

  • Prevention of excessive fluid intake and regulation of fluid intake
  • Limiting the consumption of coffee, tea, alcohol and carbonated beverages
  • Ensuring weight loss and regular physical exercise in obese patients
  • Relieving constipation
  • Avoiding spicy, spicy and sour foods that irritate the bladder
  • Encouraging smokers to quit
  • Urination training and exercises to strengthen the pelvic floor muscles

Drug Treatment: Drug treatments are arranged according to the type of urinary incontinence disorder. The main drugs used in treatment are muscarinic receptor antagonists, mirabegron and estrogen. Other medications include desmopressin and duloxetine. Since these drugs may have some negative side effects and interaction with other drugs, they should be used under the supervision of a urologist.

Surgical treatmen

For Impingement Type Urinary Incontinence:

  1. Intrabladder Botox Application: It is a treatment method we use in the treatment of overactive bladder, neurogenic bladder and painful bladder syndromes. In this procedure, which we frequently apply under local anesthesia, botox injection is applied to 20-30 points of the bladder with the help of a special needle.

    In this procedure, which has an activity of approximately 6-12 months, it is aimed to reduce the involuntary bladder contractions of the patients and to increase the bladder capacity, thus improving the complaints such as frequent urination and urinary incontinence.

  1. Sacral Neuromodulation (Bladder Pacemaker): It is used in the treatment of urinary incontinence, inability to urinate, resistant overactive bladder and painful bladder syndrome. In this technique, which is called sacral neuromodulation (bladder pacemaker), the electrodes we place in the sacrum bone stimulate the nerves that provide the functions of the bladder with the help of a battery and provide relief from the patient’s complaints.
  2. Bladder Augmentation Surgery (Augmentation)

For Stress Type Urinary Incontinence,;

  1. Tape Surgeries (TOT & TVT) It is the support to prevent urinary incontinence with the help of a tape placed in the patient’s vagina. If there is no prolapse in the uterus or bladder, this surgery lasts for 15 minutes and the problem of urinary incontinence is successfully solved without any serious side effects, with en efficiency rate up to 90%. The patient is hospitalized the day before the surgery, and is discharged from the hospital on the day of the surgery. The effect of the surgery is observed the very next day.
  2. Burch Colposuspension
  3. Periurethral Injection
  4. Artifical Urinary Sphincter

NOTE: The content of the page is for informational purposes only, consult your doctor for diagnosis and treatment.