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Urology
Urinary Incontinence
Urinary incontinence is any kind of involuntary leakage of urine. It is a symptom of an underlying anatomical or functional disorder. It is seen much more frequently in women than in men due to pelvic floor structure, pregnancy, and menopause.
ℹWhat is Urinary Incontinence?
For the urinary bladder (vesica) to store urine, the bladder muscle must relax and the sphincter muscles must contract strongly. The uncontrolled flow of urine from the urethra is called incontinence.
This problem, which directly affects women's health and quality of life, can be successfully treated with today's effective treatment methods.
Common Symptoms
Stress Incontinence
Leakage during activities that increase intra-abdominal pressure such as coughing, sneezing, laughing, or heavy lifting.
Urge Incontinence
Involuntary leakage accompanied by a sudden, strong urge to void. Associated with Overactive Bladder.
Mixed Incontinence
Coexistence of both stress and urge incontinence.
Overflow Incontinence
Drip-by-drip leakage due to the bladder exceeding its capacity as a result of incomplete emptying.
Diagnosis Methods
Physical Examination
Pelvic exam, cough stress test, neurological assessment, and pad test.
Voiding Diary
Recording fluid intake and urine output over 2-3 days.
Urodynamic Testing
The most detailed test measuring bladder pressure-volume relationship and functional capacity.
Ultrasonography
Measurement of post-void residual urine volume (PVR).
Causes
Pregnancy and Childbirth
Particularly difficult or multiple vaginal deliveries can weaken pelvic floor muscles and nerves.
Menopause
Decreased estrogen leads to weakening of urethral and bladder tissues.
Aging
Decreased elasticity of the bladder muscles.
Obesity
Increases chronic pressure on pelvic floor muscles.
Past Operations
Surgeries such as hysterectomy can affect bladder support.
Chronic Diseases
Diabetes, Multiple Sclerosis, or pulmonary diseases causing chronic cough.
Treatments
Pelvic Floor Exercises (Kegel)
Conservative treatment through muscle strengthening and bladder training.
Anticholinergic Therapy
Blocks the "contract" signal to the bladder muscle, increasing capacity. Oxybutynin, Solifenacin, Tolterodine.
Beta-3 Agonist Therapy
Promotes bladder relaxation during the storage phase. Mirabegron (Betmiga).
Sling Surgeries (TOT, TVT)
Providing support by placing a synthetic mesh under the urethra in stress incontinence.
Burch Colposuspension
A suspension operation performed through the abdominal region.
Robotic Sacrocolpopexy
Simultaneous correction of prolapse and incontinence when concomitant pelvic organ prolapse is present.
Prevention
Lifestyle Changes
Limitation of caffeine, alcohol, and acidic beverages; weight control.
Pelvic Floor Strengthening
Strengthening pelvic floor muscles through regular Kegel exercises.