This year's theme of Urology Week, organized by the European Association of Urology on September 20-24 to draw attention to urological diseases, is incontinence, the problem of urinary incontinence, which is very common in women. Urinary incontinence, which affects approximately one in every two women, can be encountered both in childhood and in later ages. Saying that untreated urinary incontinence can cause recurrent urinary tract infections and very serious psychosocial problems, Anadolu Health Center Urology Specialist Dr. Elnur Allahverdiyev said, “Urinary incontinence can be caused by many different reasons. With conscious and good treatment, urinary incontinence pronlem can be solved to a great extent. The most important point here is to determine the cause of urinary incontinence in the patient and to stay away from factors that negatively affect urinary incontinence.
In order for the bladder to empty the urine easily, the bladder neck and urinary canal should expand a little during urination and should not interfere with the urine flow. At the end of urination, the muscles in the bladder neck and urinary canal contract, ensuring that there is no urinary incontinence until the next urination. Stating that the factors affecting the filling and emptying functions of the bladder can cause different types of urinary incontinence, Anadolu Health Center Urology Specialist Dr. Elnur Allahverdiyev said, “As incontinence can be caused by many different reasons, various factors can cause it. Stress, squeezing, mixed type (squeeze-stress), overflow type (because the bladder cannot empty) and continuous (fistula) types of urinary incontinence can be seen. Here, the type and severity of urinary incontinence are important. Urinary incontinence treatment may differ depending on the number of pads or diapers that the patient changes daily.
Exercise strengthens bladder muscles
Stressing that stress urinary incontinence can be seen when coughing, sneezing, moving, laughing, talking loudly, that is, in any situation that increases the pressure in the abdomen, Urology Specialist Dr. Elnur Allahverdiyev said, “This situation can be caused by the loss or a decrease in the strength of the muscles in the neck of urine, which are used to hold. If the number of pads used daily is low and the patient is a motivated patient, we can strengthen the muscles in the bladder by exercising in stress urinary incontinence, and thus we can achieve a success rate of 50-70%.
Various diseases can cause urge urinary incontinence.
Urinary incontinence does not occur due to physical activity of the patient; Urinary incontinence occurs because of the excessive urge to urinate, the occurrence of involuntary contractions and spasms, and the inability of the muscles that hold the urine to resist this situation. Urology Specialist Dr. Elnur Allahverdiyev said, “In this type of urge urinary incontinence, there is usually an underlying neural or different cause that stimulates the bladder. This can cause urinary incontinence, an overactive bladder, any foreign material in contact with the bladder (stone, suture, mesh) or at a point in contact with the bladder – inflammations in neighboring organs, excessive urge to urinate, frequent urination, involuntary contractions in the bladder. may cause evasion. If there is any dysfunction in the nervous system and it is at a point that will affect the bladder, this can also cause urge urinary incontinence. For this reason, patients with urinary incontinence due to urge should be evaluated and if there is any disease that may cause this condition, that disease should be treated. If there is no sign of disease, the patient can start appropriate diet therapy as a first-line treatment and it may be necessary to avoid agents such as coffee, cigarettes, and dark tea that stimulate the bladder.
Decision is made according to the dominant factor in urinary incontinence caused by stress and urge
Stating that another type of urinary incontinence can be both stress-induced and urge-induced urinary incontinence, Urology Specialist Dr. Elnur Allahverdiyev said, “We call the combination of the two as 'mixed urinary incontinence'. In this case, we evaluate the patient first. If the patient's stress urinary incontinence is dominant, we first apply stress urinary incontinence treatment. If the patient's urge urinary incontinence is dominant, then we first treat the urge type, then we give stress urinary incontinence treatment.
Patient history is important in overflow, leakage and persistent urinary incontinence.
Urology Specialist, who said that another urinary incontinence can occur in the form of gradual enlargement and leakage due to the narrowness of the urinary canal in the neck of the bladder, since the bladder does not empty. Elnur Allahverdiyev said, “In cases of both leaking and persistent urinary incontinence, it should be evaluated whether the patient's history includes surgery, radiation therapy or neurological diseases. In these cases of urinary incontinence, an underlying urinary canal stricture, bladder dysfunction, possible fistula between the urinary system and the vagina and uterus is sought. It should be investigated whether there is a voiding pathology or not," he said.
Problems such as urinary incontinence need to be considered in childhood. Stating that urination problems and incomplete emptying of the bladder in children should be controlled with timely and correct treatment without causing serious problems, Dr. Elnur Allahverdiyev said, “If there is only night abduction without complaints, these children are expected to be 5 years old without treatment. If it does not improve after the age of 5, a specialist should be consulted for treatment.