Although it is not a life-threatening problem, urinary incontinence, which is a discomfort that shows great psychological and sociological effects in women, is often kept as a secret in our society and is a condition that people are embarrassed to tell even the doctor.

Explaining that urinary incontinence, which can cause infections in the vagina and sometimes even sexual problems due to constant wetness and pad use, may be due to many reasons, Dr. Cem Şah, Urology Specialist at Medline Adana Hospital gives information about this disease and its treatment, which affects almost half of women.

It mostly affects women

Urinary incontinence is a common problem in the society and this condition mostly affects women. When we look at the literature, it is seen that it is 2-3 times more common than men. This problem, which begins to be seen especially in women over the age of 30, affects more than 40 percent of women after the age of 60. Since it is perceived almost as a part of normal life due to embarrassment and frequent occurrence in the society, the rate of consultation to the doctor is also low. Sexual and psychological problems, lack of self-confidence, unrest and depression are more common in women suffering from this disease.

The disease can have many causes

The problem can occur due to many reasons. Older ages, obesity, smoking, asthma and chronic bronchitis, infections that may occur in the bladder or vagina, some medications, menopause, bladder stones or tumours, removal of the uterus, complicated births, hormonal changes, some neurological diseases, bladder outlet obstruction may be the causes of urinary incontinence. There are 3 types of this disease:

Urge incontinence

The incidence is 25 to 30 percent. It is urinary incontinence that occurs with or immediately after the sudden sense to urinate as if it is very urgent. The main cause is unknown for the vast majority of patients who consult a doctor with this problem. As the bladder is filled with incoming urine, sudden and uncontrolled contractions occur. As a result of these uncontrolled contractions, urgent urination and urinary incontinence occur.

Stress urinary incontinence

It is a type of urinary incontinence caused by situations where intra-abdominal pressure increases such as sneezing, straining, jumping, coughing. It affects about 30 to 35 percent of women, and occurs as a result of weakening of the anatomical support structures of the bladder neck and urethra. Women who consult a specialist due to this complaint may also have partial or severe prolapse of the uterus and the base of the bladder downwards, that is, towards the vagina.

Mixed urinary incontinence

It is the most common type of urinary incontinence, which is a combination of stress and urge urinary incontinence. The incidence among women is about 40 percent.

Two treatment options

Treatment options for urinary incontinence are ‘non-surgical methods’ and ‘surgical methods’.

Non-surgical methods

Medication: Anticholinergic drugs that prevent involuntary bladder contractions are used.

Dietary and lifestyle changes: A daily fluid intake of at least 1500 ml is recommended. Reducing the intake of alcohol, acidic liquids and foods, consumption of caffeinated liquids (coke, tea-coffee, chocolate) reduces the severity of the disease. It is also recommended to avoid hot, spicy and acidic foods. It is important to treat constipation and control diabetes, if any.

Pelvic floor muscle exercises (Kegel): It is aimed to act as if the muscles surrounding the vagina and anus will stop urine and gas outflow by contracting together. The duration and number of these exercises are increased day by day.

Bladder training: It is a programme in which the patient is taught to urinate only at certain times with increasing weekly periods and lasts 6-8 weeks depending on patient compliance. Maintaining ideal weight and quitting smoking is a method that has an effect on all types of urinary incontinence.

Surgical method

The surgical method is practical and has a high chance of success. Scientific studies have shown that the main cause of urinary incontinence is ‘insufficient muscle support at the pelvic floor’. Especially in stress urinary incontinence, sling surgeries, which have been popular in recent years, are performed with regional anaesthesia method without the need for general anaesthesia. This method, which does not require hospitalisation, provides almost 90 percent success rate. Botox injection into the bladder may also be preferred as a surgical option in urge urinary incontinence resistant to medical treatment.