What is Urinary Incontinence?

Urinary incontinence is defined as inability of urine storage. It has a wide range of causes, from temporary incontinence for a few days, which may be due to urinary tract infection, to permanent urinary incontinence that may develop after cancer surgeries. The incidence is higher for the female gender.

Urinary Incontinence Causes

• Advanced age,
• Obesity,
• Weakness of pelvic muscles and structures,
• Births and pregnancies,
• Neurological diseases,
• Menopause,
• Prostate cancer surgeries,
• Radiotherapy,
• Past pelvic and retroperitoneal surgeries,
• Overactive bladder,
• Diabetes,
• Urinary tract infection.

Types of Urinary Incontinence

Stress incontinence: It is a type of urinary incontinence that occurs in situations where intra-abdominal pressure increases such as coughing, laughing, sneezing, and heavy lifting. It develops due to the insufficiency of the pelvic floor muscles surrounding the bladder neck, sphincter structure (urinary holding muscle) and urethra (urinary canal). More anatomical factors are effective. Surgical operations are often required for its treatment.

Urgency type incontinence: It is a type of urinary incontinence that appears suddenly and develops before reaching the WC. It may be a component of overactive bladder disease.

Mixt type incontinence: There can be both stress and urge urinary incontinence.

Overflow incontinence: It is the type of urinary incontinence in which the bladder cannot be emptied sufficiently and its capacity overflows. It may develop secondary to obstruction-related events such as prostate enlargement, or it may occur due to reasons such as MS and diabetes that cause sensory damage to the urinary bladder.

Urinary Incontinence Diagnostic Methods

One or more of the urinalysis, fasting blood glucose, urine culture, uroflowmetry, urodynamics, ultrasonography and cystoscopic examinations are performed according to the patient's history and physical examination.

Urinary Incontinence Treatment

Treatment of urinary incontinence varies according to the cause. For example, just a few days of antibiotic therapy is sufficient for simple cystitis, but surgical intervention may be required in stress incontinence. All patients should implement some lifestyle changes before specific treatments.

• Returning to normal body mass index for overweight patients,
• Blood sugar regulation for diabetic patients,
• Avoiding tea, coffee, bitter, spice and carbonated drinks as much as possible,
• Strengthening the pelvic floor muscles,
• Doing regular sports,
• Regulation of fluid intake.

Urinary Incontinence Surgery

Stress incontinence: Today, the most commonly used surgical method for this type of urinary incontinence is trans obturatory tape (TOT) or trans vaginal tape (TVT) operations. Patient selection is very important for this very effective method. In addition, patients should be informed about the artificial mesh (patch, sling material) used in these sling operations.

Stress urinary incontinence seen in men usually occurs after prostate and bladder cancer surgery. In this case, treatment can be provided by placing an artificial urinary sphincter

Overactive bladder: Although this type of urinary incontinence is mostly successful with drug treatment, intravesical b*o*t*o*x application, bladder battery and bladder augmentation operations may be required in resistant cases. In particular, b*o*t*o*x application is frequently preferred because it is simple and can be applied even with local anesthesia.

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