A GENERAL OVERVIEW OF URINARY INCONTINENCE
Involuntary urination (urinary incontinence) is a problem that affects many women. Many women who fear urinary incontinence cannot even leave their homes and become socially isolated. The frequency of urinary incontinence increases with age. Although rare in young women, urinary incontinence can occur. Urinary incontinence is not a necessity of aging. Urinary incontinence is a disease and it has a solution. You don’t have to live with it.
TYPES OF URINARY INCONTINENCE
There are two types of urinary incontinence most commonly encountered in women. These are stress urinary incontinence and urge urinary incontinence. Urinary incontinence can increase due to being overweight, diabetes, or urinary tract infection.
Stress Urinary Incontinence: Stress urinary incontinence occurs when the muscles and tissues around the urethra (where urine exits) cannot close properly when pressure in our abdomen increases, resulting in involuntary urine leakage. Normally, the muscles in the front wall of the vagina and under the urethra ensure that the urethra closes tightly during activities. When the support of the urethra weakens or the urethral muscle fails to close properly, any increase in abdominal pressure can lead to leakage. Stress incontinence can be caused by activities such as coughing, sneezing, laughing, jumping, lifting heavy objects, or running, which increase intra-abdominal pressure. Stress incontinence is more common in overweight and parous women.
Urge Urinary Incontinence: In women with urge urinary incontinence (also known as overactive bladder), there is a sudden, uncontrollable urge to urinate, but you leak urine before you can get to the toilet. Situations that can increase urge urinary incontinence include unlocking the door when you come home, going outside in the cold, turning on the tap, or washing your hands.
Many women with complaints of urinary incontinence due to overactive bladder often go to the toilet frequently day and night. If you urinate more than 9 times during the day and more than once at night, this is considered abnormal. Of course, drinking too much water affects urination frequency. Overactive bladder can also be observed after stroke and Parkinson’s disease.
Mixed Urinary Incontinence: Mixed urinary incontinence refers to urinary leakage in women who have both stress and urge urinary incontinence.
Overflow Urinary Incontinence: Overflow urinary incontinence is much rarer compared to other types of urinary incontinence. It occurs when the bladder does not completely empty after urination, and when the bladder is overly full, it results in leakage. Overflow incontinence can cause symptoms similar to stress or urge incontinence, and it can be caused by urethral obstruction, weakening of the bladder muscle, or prolapse of the uterus.
HOW IS URINARY INCONTINENCE DIAGNOSED?
Although talking about urinary leakage is difficult, weight control, pelvic floor muscle exercises, and/or medications can often be used to treat obese women. The first step you need to take is to talk to your experienced gynecologist about your urinary incontinence problem. You need to tell your doctor in detail when your urinary incontinence complaint occurs. Do you have a sudden urge to urinate and leak before reaching the toilet, or do you only leak when coughing or sneezing? How many months or years have you had this complaint? Have you seen a doctor before for bedwetting or urinary incontinence? Do you have diabetes? Is your urine red or have you seen blood in your urine? The answers to these questions are crucial for us to diagnose and plan treatment for your urinary leakage.
Bladder Diary: Keeping track of the number and amount of urination in a daily diary involves writing down how much urine you pass and how often you urinate within a day. You should record how much water or other fluids you consume, how much you urinate, and if you experience urinary leakage and the activities that cause leakage. These records will help us to understand your urinary incontinence complaint.
Examination: A general examination is performed to evaluate you in terms of urinary incontinence. A brief neurological examination is started to assess any loss of strength in the legs. A pelvic examination is usually required to fully understand the cause of urinary incontinence, and the pelvic examination includes a speculum examination to evaluate pelvic organ prolapse and pelvic masses.
Tests: Easy tests can be performed during the examination to determine the type of urinary leakage you are experiencing. This may include an assessment of urinary leakage when your bladder is full and you are asked to cough, while your doctor or nurse observes you. A urine culture test is necessary to determine if there is an infection in the urine. A test can be performed to see how well you empty your bladder when you urinate. This may include inserting a small temporary catheter into the bladder or evaluating the amount of urine left in the bladder after urination using ultrasound.