Commonly known as urinary incontinence, stress incontinence is the involuntary leakage of urine during moments of increased abdominal pressure, such as when laughing, coughing, or lifting heavy objects. Another form of urinary incontinence involves leakage when going to the toilet, during the night, or regularly, unrelated to increased abdominal pressure. This is generally caused by a nervous system disorder. Urine leakage from the vagina, rather than the urethra, is a condition caused by a fistula. This article will focus solely on stress incontinence, which occurs when there is increased abdominal pressure.
The cause of stress incontinence is entirely due to an anatomical lesion. In this condition, the normal angle between the bladder and the urethra is disrupted.
Treatment
With the help of a specialist, stress incontinence can be treated. The cause and type of incontinence are determined, and an appropriate surgical procedure is performed. The disrupted angle between the bladder and urethra is reconstructed through a minor surgical intervention, resolving the patient’s discomfort.
There are various treatment methods and solutions available to address this problem, which can significantly impact the quality of daily life, affecting work, social interactions, and personal well-being. This condition, observed in both men and women, has different types, causes, and corresponding treatments. Urinary incontinence is a prevalent and treatable problem. It is not considered a disease as it can occur in any gender and age group. There are multiple types and treatment methods, and the chosen treatment approach varies depending on the specific condition of the incontinence. Generally, the condition is addressed with medication and surgical intervention, depending on the situation. Let’s examine these treatment methods:
Non-Surgical Treatment Methods
The goal here is to improve and correct the factors contributing to involuntary urine leakage. Non-surgical treatment methods aim to address aggravating factors such as constipation, obesity, smoking, excessive fluid intake, and improve the patient’s pelvic floor muscle strength to manage increased abdominal pressure, and correct any hormonal imbalances.
Treatment with Kegel Exercises:
The pelvis is the area between the pelvic bones. During childbirth, this is the pathway the baby follows. There are numerous muscles in the pelvic region. Pelvic floor muscle training involves contracting these muscles while urinating, stopping the urine flow for a short period, and then relaxing the muscles. The goal is to learn which muscle group to contract and relax. Once identified, these muscles should be contracted and relaxed 200 times a day. This should be done in sets of 5 slow and 5 fast contractions, at least 5 times a day. During pregnancy, it should be performed at least 3 times a day, and after delivery, at least 10 times a day. Kegel exercises can prevent urinary incontinence, especially common after childbirth due to coughing, sneezing, and laughing.
Treatment with Medication:
Doctors specializing in this field may prescribe medications to relax the bladder, providing relief for suitable patients.
Surgical Treatment Methods:
The definitive treatment for stress incontinence is surgical intervention. There are various surgical procedures currently employed to correct this problem.
Types of Stress Incontinence (Urinary Incontinence)
Urinary incontinence is generally categorized into three main groups:
- Stress Incontinence: Urinary incontinence related to muscle and nerve weakness.
- Urge Incontinence: Urinary incontinence due to uncontrolled automatic contractions of the bladder.
- Mixed Type: Urinary incontinence with the presence of both conditions.
What are the causes of urinary incontinence?
- Advancing age
- Being overweight, obesity
- Hereditary factors
- Constipation
- Urinary tract infections (cystitis, bladder inflammation in women)
- Vaginal infections
- Urinary stones and tumors
- Difficult childbirth
- Menopause-related hormonal changes
- Radiation therapy
- Neurological diseases and prostate enlargement in men
- Connections between the bladder and vagina or between the kidney and bladder (ureter) in women can cause persistent urinary incontinence.
- Uncontrolled diabetes
- Alcoholism
- Surgeries for prostate cancer
- Medications like muscle relaxants, blood pressure medications, diuretics, tranquilizers, antidepressants, and allergy medications can also cause urinary incontinence.
- Diseases that cause a decline in brain function (dementia, Alzheimer’s, vascular diseases, etc.)
These factors can generally be considered as causes of urinary incontinence.
How is urinary incontinence diagnosed?
The diagnosis can be comfortably made through a physical examination, a daily urine tracking chart, a pad test to determine the amount of urine leakage, and, if necessary, urodynamic tests to assess bladder function.
Urinary Incontinence in Men
Men experience this problem less frequently than women. The muscle structures responsible for urinary control are physiologically stronger in men. Furthermore, as they do not experience childbirth, they are less prone to this issue. Therefore, urinary incontinence is generally less common in men compared to women. However, if it does occur, it can be said that men experience this condition more severely than women.
Most Common Causes of Urinary Incontinence in Men:
The most common causes include urinary incontinence due to untreated bladder outlet obstruction associated with prostate enlargement and urinary incontinence following prostate surgeries.
Urinary Incontinence in Women and its Causes:
Urinary incontinence, especially prevalent after menopause and in women with multiple childbirths, is a serious and common problem affecting approximately one in four women over the age of 30. It can even occur in young women who have never given birth. With increasing life expectancy in women, this problem can become even more significant. One of the most serious causes of urinary incontinence complaints in women is genetic predisposition. In women with genetically weak connective tissue prone to sagging, this problem frequently occurs. Genital organ prolapse often occurs due to difficult and frequent childbirth, chronic cough and asthma, heavy lifting, chronic constipation, and excess weight, ultimately leading to urinary incontinence.
For Treatment in Istanbul
For the diagnosis and treatment of stress urinary incontinence, overactive bladder, mixed incontinence, overflow incontinence, functional incontinence, reflex incontinence, and temporary urinary incontinence, you can contact Prof. Dr. Ateş Karateke in Istanbul.