Urinary incontinence, a problem that can happen to any woman, can negatively affect a person's daily life if it becomes chronic. Especially within social life, this condition can lead to a loss of self-confidence and gradually become very distressing.

Treatment is necessary to prevent this condition and to help the muscles that control the urinary process regain their normal function.

What is involuntary urinary incontinence?

Involuntary urinary leakage, known as urinary incontinence, is one of the unwanted situations that every woman experiences at least once in her life. Women who complain about being unable to hold their urine often avoid going outside due to the anxiety caused by this condition.

This condition occurs due to problems in the muscles and organs in the lower abdominal area (pelvic floor), also known as the bladder. Although many women accept this condition as fate, it is possible to resolve it with appropriate treatment.

What are the causes of urinary incontinence?

• Advanced age,
• Menopause due to estrogen deficiency,
• Giving birth at a young age,
• Multiple pregnancies,
• Intervention during childbirth,
• Diseases causing weakness in pelvic floor muscles,
• Obesity,
• Smoking and alcohol,
• Genetic factors,
• Having had uterine surgery,
• Neurological diseases,
• Diabetes and diabetic diseases,
• Urinary tract infections.

Who is most commonly affected?

Although it is seen more frequently in older age, this condition is not only a problem for elderly women. Urinary incontinence, which affects many aspects of life—from going outside, socializing, to engaging in sexual intercourse or avoiding it—can occur in anyone with weakened pelvic floor muscles.

It can also be seen in individuals who have had difficult births or cesarean sections.

How is urinary incontinence diagnosed?

The doctor asks detailed questions to accurately determine the patient's medical history. This process, called anamnesis, may include questions such as:

• Do you consume tobacco or alcohol?
• How much fluid do you intake daily?
• Are you taking any medications? If yes, what are they?
• Have you ever undergone any surgical operation?
• Have you ever been pregnant?
• What was the mode of delivery?
• Are you menopausal?
• Do you leak urine when laughing, sneezing, or coughing?
• Do you sometimes not make it to the toilet in time?
• Do you feel like your bladder does not empty completely after urination? And so on...

A physical examination follows. An ultrasound is used to check the current condition of the pelvic area. Patients may be asked to keep a voiding diary to track how often they go to the toilet. Urine tests and cultures are then performed.

Urodynamic tests are applied. If there is residual urine in the bladder, a catheter measures the amount remaining. A treatment approach is determined based on the results.

What are the types of urinary incontinence?

The types vary depending on when and how the patient leaks urine. Accordingly;

• Stress urinary incontinence: This usually occurs due to weak muscles and bladder support. The person leaks urine during coughing, sneezing, or laughing because the pressure in the bladder increases at these moments, making it impossible to hold urine.
• Overflow urinary incontinence: It mainly occurs due to bladder weakness but can also be caused by many other reasons. It develops due to blockage that prevents normal urine flow from the bladder.
• Urgency urinary incontinence: This occurs when the muscles active during urination unexpectedly contract, causing a sudden need to urinate.

Treatment of urinary incontinence with surgery

In addition to medication, Kegel exercises, Botox injections into the bladder, and nerve stimulation, surgical procedures are the most effective methods preferred for urinary incontinence treatment. Colposuspension (retropubic urethropexy) (BURCH, paravaginal repair), pubovaginal sling (urethropexy), minimally invasive slings (TOT, TVT), periurethral and transurethral injections, and artificial sphincters are among the surgical approaches.

The most commonly performed operations are TOT and TVT. Transvaginal tape (TVT) and transobturator tape (TOT) are methods that support the bladder with a band and are applied practically with small incisions without bleeding. This procedure strengthens weakened ligaments and restores sagging tissues to their normal position using a suspension technique. Recovery and return to normal life after surgery are quite short. This method has a high success rate, causes much less pain, and leaves no scars since no abdominal incision is made.

We wish you healthy days.