Urinary incontinence is the sudden and involuntary release of urine from the urethra during normal daily activities. Urinary incontinence, which is observed in 15-55% of the entire female population, is a treatable condition. Urinary incontinence can develop in women of all age groups due to different reasons. However, urinary incontinence is definitely not a normal result of the aging process.
Urinary incontinence is a condition that people cannot talk about easily. It can be embarrassing and uncomfortable. It can limit the activities you enjoy (exercise, traveling, social relationships, etc.) or it can be severe enough to limit daily life. There are many solutions available today to get rid of this problem, which can affect your professional, social and personal activities, to return to a free life as before and to improve your quality of life.
TYPES OF URINARY INCONTINENCE
Urinary incontinence in women has been defined as 4 different types.
✅ STRESS URINARY INCONTINENCE
Involuntary urinary incontinence with sudden movements such as laughing, coughing, sneezing, walking or exercising. It is the most common type of urinary incontinence in women. There are two causes; the first and most common one is weakness of the pelvic floor muscles. Pelvic floor muscles support the lower urinary tract organs. A strong pelvic floor keeps the urethra closed until it is time to urinate. When there is pelvic floor weakness, situations that increase the internal abdominal pressure (exercise, coughing, etc.) cause the urethra to open and urinary incontinence. Risk factors include multiple intervention deliveries, giving birth to large babies, obesity, familial predisposition and menopause.
Another cause of stress urinary incontinence is the inadequacy of the internal sphincter muscles (muscles that control bladder emptying). Normally, the sphincter muscles keep the urethra closed while the bladder is filling and relax when it is time to urinate, allowing urination. In the presence of sphincter insufficiency, urine is missed during various movements (coughing, exercise, etc.) because the muscles cannot perform their duties.
URGE URINARY INCONTINENCE
It is a form of urinary incontinence when there is a strong need to go to the toilet and you cannot reach the toilet. Unlike stress urinary incontinence, the cause is not weakness in the pelvic floor, but overactive, involuntary contraction of the bladder muscles.
✅ MYX TYPE URINARY INCONTINENCE
It is a combination of stress urinary incontinence and urge urinary incontinence.
✅ OVERFLOW TYPE URINARY INCONTINENCE
When urine is stored in the bladder above capacity, it is the incontinence of small amounts of urine without feeling the need to urinate. The bladder remains full again. The person feels that they cannot empty their bladder completely. Diebet pelvic injury occurs as a result of loss of muscle tone in conditions such as extensive pelvic surgery, spinal cord injuries and multiple sclerosis.
TREATMENT OF URINARY INCONTINENCE
Urinary incontinence can be treated at any age. However, not every treatment method is useful for every type of incontinence;
TREATMENT METHODS IN STRESS TYPE URINARY INCONTINENCE
✅ BEHAVIORAL THERAPIES and Pelvic Floor Exercises
The first step is kegel exercises, which are exercises to strengthen the pelvic floor muscles. With this treatment, the pelvic floor muscles are strengthened by controlling the muscles related to the bladder and urination. In addition to these exercises, a urinary diary is created and bladder training is tried to be provided within the framework of a program. Other treatment methods used in combination with these exercises or alone are biofeedback and electrical simulation. These methods strengthen the pelvic floor muscles.
✅ DRUG TREATMENT:
Some types of urinary incontinence can be treated with medication or hormones. Especially in urge incontinence, the treatment option is drug therapy and drugs are used to reduce overactive muscle activity. However, stress-type urinary incontinence does not respond to drug treatment. In some cases, local estrogen creams, patches or tablets can be applied, although rarely.
✅ SURGICAL TREATMENT:
If other treatment approaches fail, surgical intervention may be necessary to address the underlying cause of urinary incontinence. There are many options for surgical intervention and each may be recommended depending on the type or cause of urinary incontinence.
✅ BLADDER NECK SUSPENSION OPERATIONS
Retropubic suspension operations (Burch, MMK)
Needle suspension operations (Stamey, Pereya, Raz)
Suburethral and midurethral suspension operations (TVT, TVT Obturator, Vaginal sling - Needleless System)
✅ PERIURETHRAL PLICATION OPERATIONS (KELLY, KENNEDY)
✅ PERIURETHRAL INJECTIONS (TEFLON, SILICONE)
✅ ARTIFICIAL STERNUM
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