Gynecology
What is urinary incontinence in women?
Urinary incontinence, medically defined as urinary incontinence, is uncontrollable and involuntary urinary incontinence. Every second woman experiences urinary incontinence at some point in her life. The incidence increases with age. Since there is not enough information about how to deal with urinary incontinence in the society, many women continue to live with this unwanted situation. Having to cope with urinary incontinence has a negative impact on women's social lives and self-esteem.
What are the types and causes of urinary incontinence?
Stress incontinence: Involuntary urinary incontinence that occurs in situations where intra-abdominal pressure increases, such as exertion, exercise, laughing, straining or coughing. The main problem is caused by deterioration in the supportive tissues related to the genital area such as ligaments, muscles and ligaments in women. In addition, nervous stimulation disorders can also cause this type of urinary incontinence.
Urge incontinence (Urge incontinence): In this case, the patient suddenly urinates and urinates uncontrollably with a sense of urgency. The urinary bladder It is a sudden, uncontrolled contraction of the bladder. The most important cause is the lack of coordination between the bladder muscles and the nerve impulse. Diabetes, Parkinson's disease, multiple sclerosis and diseases that disrupt the nerve impulse system are some of the common causes.
Mixed (Mixed) type urinary incontinence: The patient has stress and urge urinary incontinence complaints together.
Continuous urinary incontinence: The patient has continuous urinary incontinence regardless of urinary sensation, position and time of day. It often develops due to the formation of anatomical alternative pathways (fistulas) between the urinary tract and the genital tract due to previous surgical procedures or radiotherapy treatment.
Overflow urinary incontinence: It is urinary incontinence that occurs as a result of overflow of urine as a result of exceeding the storage capacity of the bladder. The patient does not have a full urinary sensation and the patient suddenly starts to leak as the reserve is filled and the urine overflows. Patients empty the bladder frequently during the daytime to avoid such a situation. However, complaints increase at night during sleep.
How is urinary incontinence evaluated and diagnosed?
Although urinary incontinence is a disease that significantly impairs quality of life, it is a condition that can be resolved. The first step in diagnosis is to listen to the detailed patient history and to question every concept that may cause this situation in detail. Afterwards, anatomical disorders that may cause urinary incontinence are evaluated with a physical examination performed by an experienced physician. In terms of other diseases that may accompany; It is important that laboratory tests such as fasting blood sugar, complete urinalysis, and urine culture are requested on-site and appropriately. Then, if the doctor deems it appropriate, an upper examination called urodynamics may be requested from the patient in order to determine the type of urinary incontinence and to evaluate the incontinence before and after the treatment. After this algorithm, necessary applications and treatments are started to eliminate the complaints of the patients.
What are the methods used in the treatment of urinary incontinence in women? In which cases is urinary incontinence treated with surgical methods?
The most important concept before treatment is to determine the type of urinary incontinence of the patient. The first step afterward should not be surgery. In the first place; If there are additional problems such as improving living conditions, strengthening the support tissues of the region, high blood sugar that may cause urinary incontinence, and urinary tract infection, medical treatments should be planned to solve them and to provide muscle-nerve harmony. After these treatments, the patient should be re-evaluated and re-evaluated in terms of the need for surgery according to whether their complaints decrease or not. It should not be forgotten that surgery should not be the first treatment method and it should be known that surgery cannot be beneficial in every type of urinary incontinence. It is important that patients are informed and managed by experienced physicians.
What are the surgical methods used in the treatment of urinary incontinence? How long does it take to return to work and social life after the procedures?
If, as a result of all diagnosis and evaluation stages, it is decided that the patients need surgery, surgery can be performed through the vaginal and/or abdominal routes, that is, the abdomen. In all these procedures, choosing minimally invasive surgical methods that do not completely impair the patient's quality of life, that is, with small incisions, will be to the benefit of the patient. The laparoscopic approach, that is, the closed surgery or surgical interventions to be performed through the vaginal route, should be the first preferred approaches in terms of patient comfort in operations to be performed through the abdomen. If the surgery is performed in a minimally invasive manner with small incisions, as stated, patients' return to work and social life will normally not exceed 7-10 days.
What should be considered after surgical urinary incontinence treatment?
It may cause a serious increase in intra-abdominal pressure after surgery; It is important to avoid situations such as lifting heavy loads, constipation, smoking and chronic cough that may occur due to this. Again, attention should be paid to the 2-month sexual abstinence for wound healing.
