Urinary incontinence is the uncontrolled inability to hold urine and urinating at inappropriate places and times. It is one of the most difficult issues in women’s social lives that women are afraid to express. Moreover, it is seen in approximately one in every 4 women. While the incidence is so high, the number of patients who demand treatment and consult a doctor is less. Its frequency increases especially with advancing age. Women who have given birth too many times, women after menopause or difficult births may experience urinary incontinence. Sometimes it can be seen even in women who have never given birth. Patients leak urine especially when lifting heavy loads, coughing, sneezing, laughing violently. Bladder prolapse can also be seen due to difficult births.
“I can’t hold my urine!”, “I urinate every hour, I know almost every toilet!”, “I can’t go out on the street for fear, I can’t go to the neighbors!”, “I feel like I have to urinate all the time!”, “I go to the toilet frequently at night!”, “I have back and groin pain!” or “I have something down there in my hand!”. These are sentences we often hear from patients. Urinary incontinence problem causes patients to change their lifestyle and restrict their lives. By drinking less water, they experience kidney stones, urinary tract infections, and processes leading to depression may occur. Their sexual lives are also severely restricted due to reasons such as embarrassment, loss of self-confidence and fear of realizing their partners’ problems. Expressing these problems is seen as a “taboo” and these patients rarely seek help. They are ashamed to tell their complaints to the doctor or their relatives and think that these problems are normal at their age.
A detailed history is taken from the patient presenting with urinary incontinence. Situations that initiate urinary incontinence, the type and frequency of incontinence are learned. ‘Do you leak urine while coughing, sneezing or laughing? Do you leak urine at the toilet door when you are about to go to the toilet and cannot reach it? Is urinary incontinence accompanied by urinary burning or frequent urination? How long have you had urinary incontinence and how did it start?’ Questions such as these will be asked by the physician to understand the cause of urinary incontinence and to determine its type. The patient may be asked for blood sugar, urinalysis and urine culture, ultrasound and urodynamics.
There are three types of urinary incontinence. The first one is the type of urinary incontinence that occurs suddenly in situations where intra-abdominal pressure increases, such as coughing, sneezing, laughing and lifting heavy objects. This is called stress incontinence. Its treatment is surgical. In the second type, called urge incontinence, the patient suddenly urinates and passes urine uncontrollably. There is uncontrolled contraction of the bladder. Mix type is the third type and both types of urinary incontinence are present at the same time. Medical treatment initiated by physicians can be used in urge type. Patients are first treated for the cause. If the cause is weight, diet, if it is diabetes, sugar regulation, if it is smoking and alcohol use, these should be stopped. Urinary tract infections are treated with appropriate antibiotics. Exercises to strengthen the bladder and pelvic muscles are recommended. After the general evaluation of your physician, the treatment is individualized and special treatment is applied for you.
Don’t let urinary incontinence be your fate!!!