Urinary incontinence is one of the leading health problems that many people suffer from. In cases of uncontrolled urinary incontinence, the quality of life is also considerably reduced. This urine leakage is usually uncontrollable and affects life quite negatively. Success rates in the treatment of urinary incontinence are quite high. However, the problem may progress in the absence of treatment.
For this reason, people who have urinary incontinence problems should consult a doctor quickly and without hesitation. The urinary system consists of the kidneys, ureters, bladder and urethra. This system filters, stores and removes waste from the body.
The kidneys can also be described as the body’s filters. Waste products are removed from the blood by the kidneys and form urine. The urine then travels down two thin tubes called ureters.
The ureters are held in the bladder where urine is collected until it is time to leave the body. The bladder is the storehouse of urine. Therefore, when the bladder is full, the brain sends a signal that it is time to urinate. The urine is then passed out of the body by opening the sphincter, a controlled muscle.
When this system works well, incontinence is not a problem. However, the risk of incontinence increases with age. Different diseases, surgeries or hormonal problems can lead to incontinence by reducing muscle control.
What are the different types of urinary incontinence?
There are several different types of incontinence/urinary leakage. These types have different causes, characteristics and triggers for urine leakage. Identifying the type of incontinence is important for treatment.
- Urge urinary incontinence: This type of incontinence is characterized by an intense need to urinate immediately. In this case, the patient passes urine before reaching the toilet. Urge incontinence can be caused by an overactive bladder (OAB). It can be caused by weak pelvic muscles, nerve damage, infection, low estrogen levels after menopause or a heavier body weight.
- Stress incontinence: Urinary incontinence during physical activities is defined as stress-induced. Urinary incontinence may occur during coughing, lifting objects or laughing. In this type of urinary incontinence, the pelvic floor muscles are weak and this muscle weakness leads to accidental urinary incontinence while moving.
- Overflow incontinence: Overflow incontinence occurs when the bladder does not empty completely when the patient goes to the toilet. In patients with overflow incontinence, the bladder never empties completely. Therefore, overflow incontinence occurs. This type of incontinence is more common in people with chronic conditions such as multiple sclerosis (MS), stroke or diabetes.
- Mixed incontinence: This type of incontinence is a combination of several problems, all leading to leakage problems. In the case of mixed incontinence, stress incontinence and overactive bladder are present at the same time.
What are the Causes of Urinary Incontinence?
Apart from various diseases or congenital anomalies, decreased muscle function in later life is among the most common causes of urinary incontinence. Being overweight, smoking, chronic cough, constipation, asthma and similar diseases can cause urinary incontinence.
Difficult births, a history of too many normal births, diabetes, diseases affecting the central nervous system or alcohol consumption can cause urinary incontinence.
What are the Symptoms of Urinary Incontinence?
In urinary incontinence, urine may leak or drip uncontrollably. Symptoms are:
- Inability to urinate
- Pain when urinating without bladder infection
- Frequent urge to urinate
- Frequent bladder infections
How is Urinary Incontinence Diagnosed?
Cystometry: A cystometrogram is a test to measure the pressure in the bladder. In the test, the patient is asked to perform certain maneuvers while sterile water is introduced into the bladder through a catheter.
(EMG) test: The EMG test is a procedure that detects the strength of the nerves that support the muscles that allow controlled urine retention. This determines whether the muscles are in the required position.
Pelvic Ultrasound: Sound waves are used to visualize the shape and location of organs in the pelvic area.
Urinalysis: It is performed to detect infections with symptoms similar to urinary incontinence.
Cystoscopy: It is used to examine the internal structures of the bladder and the urethra, which can be called the tube connecting the bladder to the outside.
How is Urinary Incontinence Treated?
Urinary incontinence is easily treated with surgical or non-surgical techniques. Urinary incontinence is a dysfunction. Therefore, the doctor’s expertise in this field is very important in determining the causes correctly and making appropriate treatment planning.
Stress-type urinary incontinence can usually be treated with surgical techniques, while the urge type can be treated medically. In surgical methods, the abdomen is not entered. The necessary support is provided by a procedure applied to the outlet of the urinary excretory duct.
In this way, the patient can hold urine in a more controlled manner. Depending on the patient’s condition, kegel exercises may also be recommended to strengthen the pelvic muscles.
How is Urinary Incontinence Treatment Applied?
Treatment of urinary incontinence should be personalized. After determining the type of urinary incontinence, the most appropriate treatment is planned specifically for the person. Medication, laser or surgical procedures may be preferred for treatment.