Urinary incontinence is a condition that occurs in half of women in advanced age and disrupts their quality of life. Although its frequency increases with age, urinary incontinence can also occur in young patients. Urinary incontinence is not an incurable disease. Unfortunately, many women believe or do not know which doctor to consult, and thus suffer from this condition for years, despite experiencing urinary incontinence. However, consulting an experienced doctor will provide a solution after a detailed evaluation.

Urinary incontinence can be classified into two types: urgency incontinence and stress incontinence. The mechanisms of these two types of urinary incontinence are completely different, and therefore, their treatments are also very different.

Urgency incontinence, also known as overactive bladder, occurs when the nerves that stimulate our bladder suddenly become active, causing a sudden urge to urinate. Even though we try to reach the toilet urgently when the urge to urinate occurs, we often leak urine before reaching the toilet. In this type of urinary incontinence, the problem is the excessive and unnecessary stimulation of the nerves that control our bladder; therefore, medications that reduce this stimulation prevent urinary incontinence. There are several types of these medications, and the choice depends on the patient’s medical condition. Some of these medications may cause side effects such as blurred vision, constipation, and dry mouth. However, in the newer medications we use today, these side effects are either not observed or occur very rarely. In addition to medication, we also provide laser therapy and pelvic floor strengthening exercises to assist in the treatment of urinary incontinence. For patients whose urinary incontinence does not improve with medication and laser therapy, electrical treatments such as tibial nerve stimulation and bladder botox injections can be applied. However, approximately 90% of patients benefit from medication therapy. Surgery is not a good option for this group of patients and its benefits are very limited.

Another type of urinary incontinence is stress incontinence. The word “stress” in stress incontinence does not refer to psychological stress but rather to the increased pressure on the abdomen. Stress incontinence occurs during activities such as coughing, sneezing, lifting heavy objects, laughing, jumping, or exercising. This type of urinary incontinence is commonly encountered in overweight, obese, or women who have given birth. Medications have no or very limited role in the treatment of stress incontinence. The most effective treatment method is surgery. Laser therapy can be an alternative treatment for patients who do not want surgery. Kegel exercises help us in the treatment of stress incontinence. TVT (Tension-Free Vaginal Tape) and TOT (Transobturator Tape) are the most preferred surgical methods. TVT is a more effective method. The reason for the occurrence of stress incontinence is the weakening of the connection between the bladder and urethra due to reasons such as excess weight, pregnancy, and childbirth. Hanging this connection like a hammock through surgery leads to the improvement of urinary incontinence.

When both of these types of urinary incontinence occur simultaneously, it is called mixed urinary incontinence. In this case, after a detailed examination, the patient requires personalized combined treatment.

Urinary incontinence surgery usually lasts about an hour. I usually perform the transvaginal tape (TVT) surgery on my patients because it generally yields better results. In my clinic specialized in urinary incontinence in Kayseri, I plan treatment for patients coming with urinary incontinence complaints from Nevşehir, Niğde, Ankara, Kırşehir, Yozgat, and all cities of Turkey.