Urinary incontinence is one of the most common health problems regardless of age and gender. Although it is thought to be common in children and elderly individuals, it can be seen in men and women of all ages. There are many different causes of this condition, which is known as incontinence in medicine.
On the topic “What is incontinence?” We have compiled for you what you wonder and what you need to know.
WHAT IS INCONTINENCE?
Urinary incontinence is the uncontrollable incontinence of urine. This condition, which is called urinary incontinence in the medical literature, is considered a disease if it constantly happens in the person. However, urinary incontinence is not a threatening disorder in the lives of individuals, but this situation can affect individuals both socially and psychologically. In addition, it can cause problems with genital hygiene and sexual life. Therefore, it should be treated without delay.
The bladder is the name of the sac where the urine from the kidneys is collected. It is also called the bladder or urinary bladder. The relaxation and contraction of the muscles of the bladder can be controlled both by the nerves in the area and by the individual himself.
Bladder stretches as the urine is collected, so there is no pressure increase. The muscles at the lower end of the bladder also keep the mouth of the sac closed. After the bladder, there is a channel called the urethra. However, the control of this channel is provided by hormones.
TYPES OF INCONTINENCE
Urinary incontinence happens for different reasons and therefore gets different names depending on it. These are as follows:
• Stress incontinence: Urinary incontinence due to pressure build-up in the bladder by lifting heavy objects, laughing, coughing, sneezing or crying. This condition is related to muscle and nerve weakness.
• Urge urinary incontinence: This is the situation where the person suddenly urinates and looses urine uncontrollably.
• Mix type: Both conditions are seen at the same time.
WHAT ARE THE CAUSES OF URINARY INCONTINENCE?
“What causes incontinence?” are among the topics of interest. Conditions that cause urinary incontinence are as follows:
- Advancing age
- Genetics
- Obesity
- Constipation
- Vaginal infections
- Menopause
- Cystitis
- Diabetes
- Traumatic birth/births
- Prostate enlargement in men
- Dementia Alzheimer's disease
- Sagging in the urinary bladder
- Diseases of the nervous system
- Stones in the kidney or urinary tract
- Fistula between vagina and bladder
- Allergy medications
- Use of muscle relaxants, tranquilizers, blood pressure lowering and diuretic drugs
HOW IS URINARY INCONTINENCE DIAGNOSED?
For the complaint of urinary incontinence, first of all, a detailed history is taken from the patient and the conditions that may cause urinary incontinence and the frequency of urinary incontinence are considered. At this stage, ultrasound, blood glucose, urine culture, urodynamics and urinalysis may be requested from the patient.
HOW IS URINARY INCONTINENCE TREATED?
The causes of urinary incontinence experienced by the person are investigated extensively and a treatment process is planned accordingly. If the patient is above his ideal weight, the patient is given a suitable diet and exercise program. If there is constipation at the root of the situation, the person can be given the appropriate medicine. In addition, if uncontrolled diabetes is experienced, the patient's medications are regulated. Additional treatment applications are as follows:
- Excessive fluid intake of the person is prevented.
- It is desirable to reduce the use alcohol and cigarettes.
- Antibiotics are given in case of urinary tract infection.
- The person is asked to do exercises that strengthen the pelvic and bladder muscles.
There are also medication based treatments used in cases that prevent the person from holding their urine. These drugs are given by the urologist. In addition, if urinary incontinence is a condition with bladder prolapse or prostate enlargement, surgical treatment is considered.
INCONTINENCE IN CHILDREN
Bedwetting in children occurs day and night. Bedwetting at night, which is common among children, is seen in 15% of children aged 5 and over. Daytime urination occurs in 1 out of every 5 school-age children. Both night and daytime bedwetting can be improved with 3-4 months of treatment.
The methods used in the diagnosis of the condition are as follows:
- Uroflow test
- Kidney and urinary tract ultrasound
- Voiding cystourethrography
- Scintigraphy
- Urodynamics
Treatment methods for urinary incontinence in children are as follows:
- Urotherapy
- Sun-cloud calendar
- Medication
- Alarm therapy
- Surgical treatment
- Acupuncture
- Urotherapy
- Pelvic floor training
- Biofeedback
- Medication
- Interventional and surgical treatments
- Bladder augmentation surgery
- Bladder neck lengthening surgery
- Robotic surgery in children
INCONTINENCE IN FEMALES
Urinary incontinence in women can occur for many different reasons. Traumatic births, multiple births and menopause are among these causes. However, urinary incontinence can also be seen in women who have never given birth. In this case, especially heredity, heavy lifting, sneezing, laughing or coughing can be the cause.
Diagnostic Method
A detailed disease history is taken from patients who apply for the treatment of the condition. In this regard, the person's smoking, number of births, chronic disease, weight and occupation are questioned. The sexual life of the person is also examined in detail at this stage. Because a regular sexual life is effective in the development of pelvic muscles in women.
Treatment Method
Urinary incontinence usually does not require surgery. In order to understand whether the situation requires surgery or not, a profile analysis is performed for the patient and how much the situation can be prevented by lifestyle changes is examined. Then, the treatment process begins for patients who continue to have urinary incontinence as a result of lifestyle changes. If the person has urge urinary incontinence, drug treatment can be started.
The patients who respond most to the surgical method used in the treatment are those who experience stress type and mixed urinary incontinence. A voiding test can be applied to these patients before the surgical procedure. Then the surgical treatment process is planned.
The non-surgical applications used in the treatment are as follows:
- Vaginal balls
- Electromagnetic chairs
- Vaginal laser
Surgical applications used in the treatment are as follows:
- Trans Obturator Tape (TOT) surgery
- Closed laparoscopic surgery
RISK FACTORS OF URINARY INCONTINENCE IN WOMEN
“What is urinary incontinence?” seen in women. As well as the question of the risk factors of this condition, it is one of the most wondered subjects.
Age: The muscles that form the pelvic floor and prevent urinary incontinence by contracting weaken with advancing age. With this situation in the lower abdomen of the person, urinary incontinence may occur. According to studies, urge urinary incontinence increases after the age of 54, while stress urinary incontinence can be experienced after the age of 35.
Obesity: The weight gain experienced in the person damages the muscles that make up the pelvic floor. Having a body mass index above 30 therefore increases the risk of urinary incontinence. For this reason, people who experience urinary incontinence can improve with weight loss.
Pregnancy and childbirth: During birth, the nerves that control urination or the muscle structure that prevents urine from escaping in the bladder can be damaged. As a result of this situation, urinary incontinence may occur. The weight gained during pregnancy, the mode of delivery and the birth weight of the baby are also among the important factors.
Chronic Constipation: Prolonged straining with constipation causes an increase in intra-abdominal pressure. This increase in pressure prevents the muscles and nerves that control the activity of the bladder from being fed by the blood circulation, and as a result of this, urinary incontinence is experienced.
