- May 19, 2020
- Posted by: Prof Dr Coşkun Şahin
- Category: Urinary Incontinence
What is Urinary Incontinence Disease in Women?
It is called involuntary urine leakage.In other words, it refers to urine leakage that cannot be prevented outside the person’s own control. It is shown as 15-50% of women.
What are the Symptoms of Urinary Incontinence Disease in Women?
Urinary incontinence can be of different types.
Stress-type urinary incontinence: Coughing, laughing, sneezing, jumping, jumping, urine incontinence while walking up and down stairs. It is the most common type. It is seen at any age. Urgent incontinence: The urge to urinate suddenly comes here and the person passes his urine before reaching the toilet. Generally, when entering the house from the street, the patients experience the feeling of sudden jamming at the door of the house.
Mix urine incontinence: The above two types of incontinence are in the same patient
Total urinary incontinence: The patient does not understand that urine is coming. All urine escapes. Usually, the urine accumulated at night is discharged suddenly when the patient gets out of bed.
What are the Causes of Urinary Incontinence in Women?
-Gender (Being a woman)
-Bearing a large number of children (parity)
-Familial predisposition (low connective tissue elasticity) -Enter into menopause
-Long-term constipation complaints (constipation)
– Previous gynecological surgery operations can be counted.
What Are the Risk Factors of Urinary Incontinence Disease in Women?
1. Advanced Age: In aging patients, increased urination, nocturnal (nocturia) and frequent urination (urgency) can be seen with urinary incontinence; these occur as a result of weakening of the control mechanisms on the lower urinary system of the central nervous system due to aging.
2. Pregnancy: Stress-type urinary incontinence was observed more frequently in women who delivered both vaginally and cesareanly than women who did not give birth. Therefore, both pregnancy and childbirth are a risk factor for stress-type urinary incontinence. Involuntary urine leaks may occur unintentionally during pregnancy, but this is usually temporary and disappears shortly after birth. Nevertheless, in a certain segment of women who have started to complain of urinary incontinence, this complaint continues after birth. On the other hand, urinary incontinence during pregnancy increases the risk of urinary incontinence in the woman at a later age. The cause of urinary incontinence complaints during pregnancy is unknown.
3. Birth: The prevalence of stress incontinence is higher in pregnant women who have difficult labor and suffer for a long time. However, pregnant women who have a cesarean section may have urinary incontinence in the future. Again, the frequency of urinary incontinence increases in those who give birth too.
4. Obesity: Increased intra-abdominal pressure due to overweight causes an increased risk of urinary incontinence. The frequency of such complaints can be reduced with weight loss.
5. Menopause: Urinary incontinence is more common in post-menopausal periods. Replacing the estrogen hormone that decreases during menopause in these cases may reduce the complaints to some extent. However, the independent effect of aging in this period should also be considered.
What happens if urinary incontinence disease is not treated in women?
These patients sometimes avoid shyness, sometimes trying to hide their illness, maybe going to the doctor for economic problems. They ban themselves from going out on the street. The smell of urine and the concern of the environment may impair them in a sense. It may be the case of turning into individuals who live alone socially.
What Should Be Done Before the Doctor’s Appointment in Urinary Incontinence Disease in Women?
These patients should come with the examination and radiological imaging methods, if any.
What are the methods of examination of urinary incontinence in women?
The most important findings in these patients are obtained through detailed listening and answers to the questions asked. A gynecological examination is performed to look for whether there is a bladder sagging called a cystocele, a prolapse. The extent to which the patient will benefit from the surgery is tested. Rarely, a urodynamic test showing bladder functions is performed. Urinary tract infection is ruled out. With ultrasound, urine is now examined in the bladder.
Does Urinary Incontinence Improve in Women by Surgery?
Yes, it can be improved. Urinary incontinence is present in 15 to 50 percent of women. Some of them are in the form of inability to catch up, some of them are incontinent in cases where intra-abdominal pressure increases such as coughing and sneezing, some of them are mixtures of these or unannounced Hotel abduction. Especially in cases where intra-abdominal pressure is increased, 95% success is achieved with a 15-minute surgery. In other types of kidnappings, the success rate decreases a little more. Our suggestion to our patients should not experience this situation that affects themselves, their environment and social life, and come to the doctor and get treatment. This situation is not a worry.
There are many types of surgery according to the type of urinary incontinence:
It is the most popular and frequently performed surgery in recent years. The aim is to lift and fix the urethra, the urinary canal, like a hammock from below. It is a 5 minute surgery. There is a 95% chance of success in stress-type urinary incontinence. It is also used in total urinary incontinence. Success in these patients can drop to 50-70%.
The passing of synthetic material under the urinary canal, which acts as a prolene mesh, as a lifter
The procedure is carried out by passing through the canal, which is the natural cavity of the pelvis.
Laparoscopic Surgeries: Today, it is usually performed with other surgery in cases where it is entered into the abdomen for another reason.
Bulging Material: It can be applied in total types of urinary incontinence. The chances of success are low.
Artificial (Artifical) Sphincter: It is not as common in women as it is used in men. The way of treatment, which is placed around the urethra and should be considered as a tap, working with the control of the patient.
Artificial sphincter is the last but effective treatment method for female urinary incontinence types. Control of the instrument consisting of 3 parts is in the patient. When there is a feeling of voiding, it pushes the button and after 3 minutes the system automatically turns itself off. No part of the tool is visible from the outside.
Who Benefits Most From Surgery?
Young, non-overweight, non-diabetic patients who miss out on stress-type urine benefit most.
Who Should I Not Do?
It is not suitable for patients with an overactive bladder, low-capacity bladder, and those who miss urine in the form of an emergency jam. Drug therapy and surgical surgery should be considered in these patients. How is treatment planning done?
What are the side effects related to the surgery?
There are no major side effects. Rarely, there may be bleeding, inguinal pain that lasts for several days. Some patients may be allergic to the specific prolene substance used.