Although urinary incontinence is a common problem, most women find it embarrasing that they are leaking urine without knowing it and do not apply to a physician for this treatable condition. It decreases the quality of life and may increase to a socially intolerable level in time.
Women are more prone to have urinary incontince than men, because their pelvic muscles are affected by pregnancy, child birth and menaopause. Another reason is that the urethra is shorter in women and the surrounding muscles that control urination are weaker.
However female urinary incontinence management can succesfully be done after initial evaluation and most of the time simple measures may be adequate.
There are several conditions which cause urinary incontinence such as:
There are mainly four types of female urinary incontinence:
In urge urinary incontinence, there is a sudden intense urge to urinate and the bladder muscles contract rapidly to excrete urine from the bladder. The fequency of bathroom visits are increased even through the night. It may happen during sleep, after drinking even small amount of fluids, touching water or hearing the sound of water flow.
It may be caused by urinary tract infections, neurological disorders (such as Multiple sclerosis, stroke or Parkinson’s disease) or diabetes.
Female urinary incontinence medications may be necessary for this group of patients.
In stress urinary incontinence, laughing, coughing, sneezing, running or heavy lifting may exert pressure on the bladder that causes sudden involuntary loss of urine. It is also known as anatomic urinary incontinence because of the anatomic defect in the pelvic floor and disturbed urethrovesical angle.
Pelvic floor muscles and fascia may get weaker in time by menopausal hormonal changes, aging, childbirth, obesity or heavy lifting which is called pelvic relaxation. The bladder may herniate into the vagina through the fascial defect in the anterior vaginal wall which is called a cystocele.
This may change the normal angle of the urethral outlet from the bladder. Muscles controlling the outflow of urine from the urethra are weakened so that pressure on the bladder can cause involuntary leakage of urine.
In some patients both urge and stress urinary incontinence may be present together, this known as mixed urinary incontinence. These patients lose urine involuntarily with a sudden urge and with coughing, sneezing, laughing.
The bladder does not empty completely so that the remaining urine causes the bladder to become distended again and the patient to leak urine between bathroom visits.This is known as overflow urinary incontinence.
Differential diagnosis of urinary incontinence may be made by:
Urinary incontinence can be treated naturally in some patients. There are some simple measures that can be taken as a first line step in the management of female urinary incontince such as:
There is no homeopathic treatment that has been proven scientificly to treat female urinary incontinence.
There may be some non-surgical treatment alternatives recommended by your doctor as an alternative to surgery for the management of female urinary incontinence such as:
Surgical treatment may be recommended for patients with stress (anatomic) urinary incontinence. There are mainly two types of surgical procedures:
Retropubic suspension surgery is an abdominal surgery which can be performed through an incision made in the lower abdomen (belly).
This type of surgery is known as open surgery (laparatomy). It can also be performed as a closed surgery (laparoscopy) Sutures are used to elevate the bladder neck up and are attached to a ligament (Cooper’s ligament) next to the pubic bone. This surgery is known as the Burch Procedure.
The sling procedure is the placement of vaginal tissue or synthetic mesh as a hammock below the urethra through an incision on the anterior vaginal wall. The sling supports the bladder neck so that there is no leakage of urine with coughing, sneezing or exercise.
It is less invasive than the retropubic suspension surgery because no abdominal incisions are necessary.
Urinary incontinence can be easily cured in most patients by simple lifestyle modifications. The differential diagnosis must be made after a detailed patiet history physical examination and laboratory tests. Treatment may be either medical or surgical.
The treatment of female urinary incontinence depends on the cause of incontinence. Therefore the best treatment changes from one patient to the other. Urinary infection must be ruled out in all patients with incontinence, since it can easily be treated.
The problem may get worse when urinary incontinence is left untreated so that it may be more difficult to treat. When precautions are taken early enough, it may be possible to treat patients with non -surgical methods.
Female urinary incontinence is treated acoording to its cause. Detailed patient history and examination will show which tests are necessary for differential diagnosis and treatment can be planned according to the cause of urinary incontinence.
In general treatment methods can be summarised as:
It may be a sign of urinary infection in most cases when it is temporary. However there are many other reasons which can be diagnosed after patient history, physical examination and lab tests.
One of the most sophisticated methods of surgical correction of stress urinary incontinence is the sling procedure. Patient's own tissue or synthetic materilas can be used in a sling procedure to correct urethrovesical angle.
The muscles surronding the urethra (urethral sphincter) can be strengthened by regular kegel exercizes.
Medical treatment of urinary incontinence may be necessary in some cases, but the medication will be prescribed by your doctor after thorough evaluation.
There are some devices designed to help control urine leakage in women with stress urinary incontince. They may be used in patients with minimal to moderate urine leakage. Their use is similar to the insertion of a tampon into the vagina.
Can incontinence be cured in older adults? Urinary incontinence can and should be treated in patients from every age group. The problem of urine leakage not only decreases life quality, but makes the patient unwilling to leave home and socialize. Also continuous leakage leads to skin irritation and discomfort. Treatment method depends on the cause of female urinary incontinence.
Urinary incontinence work-up, medical or surgical treatment for international patients can be performed in one of our affiliated hospitals and clinics in Antalya, Ankara or Istanbul. Patients who are interested in having urinary incontinence treatment by our team can contact us through e-mail or whatsapp for detailed information.
Detailed patient history and physical examination at the first consultation will be followed up by any necessary tests. After proper urinary incontinence work-up and evaluation of etiology, medical and /or surgical treatment may be chosen. The cost will depend on the hospital, type of surgical procedue and use of special equipment.
You can visit the 'Patient Testimonials' page on our website to read the reviews of patients who have been operated by Dr. Burcu Saygan Karamürsel.
She is one of the best urinary incontinence surgeons in Turkey, having operated hundreds of patients from all over the world.
You can get in youch with us regarding female urinary incontinence treatment services and let Dr. Saygan Karamürsel assist you with professionalism and experience. After your consultation, your operation will be tailored according to your specific anatomy, because there is no one procedure that fits all patients.