Urinary incontinence affects one in every two women

Urinary incontinence affects one in every two women, This year’s theme of Urology Week, organized by the European Association of Urology on September 20-24 to draw attention to urological diseases, is incontinence, the problem of urinary incontinence, which is very common in women.¬†Urinary incontinence, which affects approximately one in every two women, can be encountered both in childhood and in later ages.¬†

In order for the bladder to empty the urine easily, the bladder neck and urethra should expand a little during urination and should not interfere with the urine flow. At the end of urination, the muscles in the bladder neck and urinary canal contract, ensuring that there is no urinary incontinence until the next urination. Factors affecting the filling and emptying functions of the bladder can cause different types of urinary incontinence. Urinary incontinence can be caused by many different reasons, and various factors can cause it. Stress, squeezing, mixed type (squeezing-stress), overflow type (because the bladder cannot be emptied) and continuous (fistula) types of urinary incontinence can be seen. Here, the type and severity of urinary incontinence are important. Urinary incontinence treatment may differ depending on the number of pads or diapers that the patient changes daily. 

Exercise strengthens bladder muscles

Stress urinary incontinence can be seen when coughing, sneezing, moving, laughing, talking loudly, that is, in any situation that increases the pressure in the abdomen. This can be caused by the loss of or a decrease in the strength of the muscles in the urinary neck, which are used to hold the urine. If the number of pads used daily is few and the patient is a motivated patient, we can strengthen the muscles in the bladder by exercising in stress urinary incontinence, and thus we can achieve a success rate of 50-70%. 

Various diseases can cause urge urinary incontinence.

Urinary incontinence does not occur due to physical activity of the patient; Urinary incontinence occurs because of the excessive urge to urinate, the occurrence of involuntary contractions and spasms, and the inability of the muscles that hold the urine to resist this situation. In this type of urge urinary incontinence, there is usually an underlying neural or different cause that stimulates the bladder. This is an overactive bladder, any foreign material in contact with the bladder (stone, suture, mesh) or at a point in contact with the bladder – inflammations in neighboring organs, excessive urge to urinate, frequent urination, involuntary contractions in the bladder. may cause evasion. If there is any dysfunction in the nervous system and it is at a point that will affect the bladder, this can also cause urinary incontinence due to urgency. For this reason, patients with urinary incontinence due to urge should be evaluated and if there is any disease that may cause this condition, that disease should be treated. If there are no signs of disease, the patient may start appropriate diet therapy as first-line treatment and it may be necessary to avoid agents such as coffee, cigarettes, and dark tea that stimulate the bladder. 

Decision is made according to the dominant factor in urinary incontinence caused by stress and urgency.

Another type of urinary incontinence is both stress-induced and urge urinary incontinence. The combination of the two is called ‘mixed urinary incontinence’. In this case, we evaluate the patient first. If the patient’s stress urinary incontinence is dominant, we first apply stress urinary incontinence treatment. If the patient’s urge urinary incontinence is dominant, then we first treat the urge type, then we give stress urinary incontinence treatment. 

Patient history is important in overflow, leakage and persistent urinary incontinence.

Another type of urinary incontinence can occur in the form of gradual enlargement and leakage, since the bladder does not empty due to the narrowing of the urinary canal in the neck of the bladder. In both leaking and persistent urinary incontinence, it should be evaluated whether the patient’s history includes surgery, radiation therapy, or neurological diseases. In these cases of urinary incontinence, an underlying urinary canal stricture, bladder dysfunction, possible fistula between the urinary system and vagina and uterus is sought. It should be investigated whether there is a voiding pathology or not. 

Problems such as urinary incontinence need to be considered in childhood. Urinary problems and incomplete emptying of the bladder in children need to be brought under control with a timely and correct treatment before they cause serious problems. If there is only nighttime incontinence without complaints, these children are expected to be without treatment until the age of 5 years. If it does not improve after the age of 5, a specialist should be consulted for treatment.

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