Urinary incontinence is one of the most common health problems affecting many people. In cases of uncontrolled urinary leakage, quality of life is significantly reduced. This urine leakage is usually uncontrollable and has a very negative impact on life. Success rates in the treatment of urinary incontinence are quite high. However, if left untreated, the problem may progress.

Therefore, individuals experiencing urinary incontinence should promptly and confidently consult a doctor. The urinary system consists of the kidneys, ureters, bladder, and urethra. This system filters, stores, and expels waste from the body.

The kidneys can be described as the body’s filters. Waste products are removed from the blood by the kidneys, forming urine. The urine then travels downward through two thin tubes called ureters.

The ureters hold the urine in the bladder, where it is stored until it is time to be expelled. The bladder is a urine reservoir. Therefore, when the bladder is full, the brain sends a signal indicating it is time to urinate. Urine is then expelled through the body by opening a muscle called the sphincter, which operates in a controlled manner.

When this system works without problems, urinary incontinence does not occur. However, the risk of incontinence increases with age. Various diseases, surgeries performed, or hormonal problems can reduce muscle control and lead to urinary leakage.

What are the different types of urinary incontinence?

There are several types of urinary incontinence. Each type has different causes, characteristics, and triggers for urine leakage. Identifying the type of incontinence is important for treatment.

• Urgency-type (Urge) urinary incontinence: This type of incontinence is characterized by a sudden and intense need to urinate. The patient leaks urine before reaching the bathroom. Urge incontinence may be caused by an overactive bladder (OAB). Causes include weak pelvic muscles, nerve damage, infection, low estrogen levels after menopause, or higher body weight.

• Stress incontinence: Urine leakage during physical activities is defined as stress-related. Leakage may occur when coughing, lifting objects, or laughing. Pelvic floor muscles are weak in this type, causing accidental leakage during movement.

• Overflow incontinence: This occurs when the bladder does not completely empty during urination. Patients with overflow incontinence never fully empty their bladder, resulting in continuous leakage. This type is more common in people with chronic illnesses such as multiple sclerosis (MS), stroke, or diabetes.

• Mixed incontinence: This type is a combination of different issues causing leakage. Mixed urinary incontinence involves both stress incontinence and overactive bladder at the same time.

What Causes Urinary Incontinence?

Aside from various diseases or congenital anomalies, decreased muscle function with advancing age is one of the most common causes of urinary incontinence. Being overweight, smoking, chronic cough, constipation, asthma, and similar conditions can also lead to urinary leakage.

Difficult births, multiple vaginal deliveries, diabetes, diseases affecting the central nervous system, or alcohol consumption can also cause urinary incontinence.

What Are the Symptoms of Urinary Incontinence?

Urinary incontinence can occur as uncontrolled dripping or leaking of urine. Symptoms include:

• Inability to urinate
• Pain during urination without bladder infection
• Frequent urge to urinate
• Frequent bladder infections

How Is Urinary Incontinence Diagnosed?

Cystometry: Cystometrogram is a test performed to measure the pressure in the bladder. During the test, the patient is asked to perform certain maneuvers while sterile water is introduced into the bladder through a catheter.

EMG Test: The EMG test measures the strength of the nerves supporting the muscles responsible for controlled urination. It determines if the muscles are in the correct position.

Pelvic Ultrasound: Sound waves are used to image the shape and position of organs in the pelvic area.

Urinalysis: Conducted to detect infections with symptoms similar to urinary incontinence.

Cystoscopy: Used to examine the inside of the bladder and the urethra, which is the tube connecting the bladder to the outside.

How Is Urinary Incontinence Treated?

Urinary incontinence can be easily treated with surgical or non-surgical techniques. It is a functional disorder, so correctly identifying its causes and planning treatment accordingly is very important, and requires the expertise of a specialist doctor.

Stress-type urinary incontinence is generally treated surgically, while urgency-type is treated medically. Surgical methods do not involve opening the abdomen. Support is provided by a procedure applied to the outlet of the urinary tract.

This allows the patient to better control urination. Pelvic muscle strengthening exercises such as Kegel exercises may also be recommended depending on the patient's condition.

How Is Urinary Incontinence Treatment Applied?

Treatment of urinary incontinence should be personalized. After identifying the type of incontinence, the most suitable treatment is planned individually.