Urinary incontinence is a curable disease that negatively affects the quality of life. Urinary incontinence reduces the self-confidence of the person, causes avoidance of sexual activity and problems in daily life.

Urinary incontinence is a disease that is seen at a rate of 30 – 40%, especially in women over the age of 30. Because it is an embracing problem, it is a disease in which there is usually patients less consult a doctor. Because of its frequent occurrence, women try to combat this problem by using absorbent pads, carrying extra underwear or drinking less fluid. However, this disease reduces the quality of life.

Today, modern medical and surgical techniques are highly advanced. This problem can be treated successfully. After treatment, women can continue their lives with more self-confidence and higher quality of life in their social lives. For this reason, it is very important to explain to patients that urinary incontinence is not a part of normal life, but a treatable disease.

Causes of Urinary Incontinence

There may be many problems on the basis of complaints such as involuntary incontinence and urinary incontinence. In some people, it can be seen in the form of urinary incontinence drop by drop in the intra-abdominal pressure such as coughing and laughing, as well as the sudden feeling of urination and inability to hold to reach the toilet. The causes vary according to the types of urinary incontinence.

Types of Urinary Incontinence

Stress Incontinence (Stress-related urinary incontinence): It occurs in the form of urinary incontinence during daily activities that increase intra-abdominal pressure, such as coughing, sneezing, laughing, standing up suddenly or lifting something heavy. It occurs as a result of weakness of the valves in the bladder and urethra.

The most important reasons are;

– Pregnancy

– Giving Birth

– Menopause

Urge Incontinence: It is the incontinence of urine due to the sudden feeling of urinating and not reaching the toilet. In this type of urinary incontinence, involuntary contractions occur in the bladder and as a result of this urine leaks.


– Urinary tract infections

– The presence of materials such as renal calculi and gravel that cause bladder irritation in the urinary tract

– Intestine problems,

– Parkinson’s disease

– Alzheimer’s disease,

– Stroke and Multiple Sclerosis

If none of these diseases are present, it is called hyperactive bladder syndrome.

How Is Urinary Incontinence Diagnosed?

– Urine analysis (investigation of signs of infection, blood in the urine, renal calculi, etc.)

– Blood tests (diabetes etc. systemic diseases are investigated.)

– Bladder capacity is checked with ultrasonography. Findings such as anomalies, tumors and stones in the bladder, kidneys and urinary tract are investigated.

– Stress test (It is observed whether there is urinary incontinence in cases that increase the intra-abdominal pressure that may cause urinary incontinence)

– Urodynamic test (The pressure of the bladder is measured during rest and urination.) It is a very important research method for the diagnosis and treatment of urinary incontinence.

Urinary Incontinence Treatment

 Treatments can be medical or surgical, and the specialist physician decides on the most appropriate treatment method according to the patient’s condition.

The first step of the therapy is in the form of physical and behavioral therapies. In case a severe anatomical problem is detected, surgical and combined treatments are used.

Surgical Applications in Urinary Incontinence Problems

The most effective surgical application in urinary incontinence is the methods performed vaginally. Besides that, surgical treatment can be performed abdominally or laparoscopically.

After the surgical intervention, the patient can be discharged one day later and can return to his/her daily life in a short time.

Sling operations are among the most commonly used surgical procedures and are based on supporting the bladder neck and urethra. In addition, TVT, TOT and mini sling techniques can be applied. These are operations that can be performed under general or spinal anesthesia that last about 15 minutes. The patient is discharged the next day after this operation. Success rates are very high and good results are obtained in the long term. Thanks to these types of surgical procedures, which have very low complication rates, the patient’s quality of life increases and self-confidence is restored.

Bladder Exercises

These are exercises involving the technique of training the bladder about delaying urination and hold urine.

Fluid intake and diet

In some patients, this problem can be overcome by weight loss, physical exercise and lifestyle changes. Reducing the consumption of alcohol, acidic and caffeine liquids can also reduce the severity of the disease.

Pelvic floor muscle exercises

These are exercises for holding and stopping urine while urinating and providing voluntary contraction of the pelvic muscles.

Drug treatments

Pharmacological drugs can also be used in the treatment of urinary incontinence. However, its use in combination with behavioral and physical treatments brings more successful results. Medications may vary depending on the patient’s condition. It is very important to continue the treatment under the control and supervision of a physician in drug treatment.

Op. Dr. Mehmet Akif GÜVENDİ

May 6, 2021