Urinary incontinence in women

All you need to know about Urinary incontinence in women in 2023

Urinary incontinence in women is a serious problem for many women as Inability to control urine in women significantly affects their quality of life, so Turkey has conducted several types of research in this field.

Urinary incontinence in women is the loss of control over urine leakage, as urine leaks out of the patient's will, which causes embarrassment and inconvenience to her. This condition increases dramatically with age.

Reasons for not controlling urine in women are too many to count, and urinary incontinence has several types and varieties. So can incontinence in women be treated permanently? What are the drugs for treating urinary incontinence in women? What are Kegel exercises for the treatment of urinary incontinence in women? Learn more in this article.

What is urinary incontinence in women?

Urinary incontinence is unintentional urination, i.e., the involuntary exit of urine. It affects men and women, but it is more common in women, especially with age.
It is difficult to say precisely how many women suffer from incontinence because many feel too embarrassed to talk about it. It can be embarrassing and upsetting for them and can affect every area of a woman's life.

A picture showing that every one in four women suffering from urinary incontinence

Some women may stop going out or being physically active because of this. Urinary incontinence can affect their sexual and social lives and relationships and sometimes lead to depression.

Types of enuresis in women

There are two main types of urinary incontinence:

Urge incontinence

With this type, women feel the sudden urge to urinate without warning, which is difficult to postpone (they have to go to the toilet immediately).

Stress incontinence

Stress incontinence occurs when you pass urine when you sneeze, cough, or strain yourself.

It can also be “mixed incontinence,” which means that some women may experience stress incontinence and urge incontinence together.

Overactive bladder occurs when you feel a strong urge to urinate more often, including at night, and sometimes this leads to urge incontinence.

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Symptoms of enuresis in women

The main symptom of incontinence is urine leakage, but this can vary slightly, from leaking a few drops to partially or completely emptying the bladder.

Women with urge incontinence may not be able to reach the toilet in time, some women also need to go to the toilet at night and sometimes leakage occurs at night too.

If you have stress incontinence, the main symptom is urine leakage when you do things like cough, sneeze and laugh, lift something heavy or exercise.

You may have other symptoms such as:

  • The need to urinate often
  • Feeling of pressure in the vagina
  • dripping urine after you go to the toilet
  • burning when urinating

Causes of urinary incontinence in women

The cause of enuresis depends on the type of incontinence and therefore varies Causes of urinary incontinence in womenAnd it varies from woman to woman.

Urge incontinence occurs when the muscle in the bladder wall contracts when you don't want it to. This makes the patient feel the need to urinate urgently. This can develop as you get older or be due to other medical conditions such as neurological diseases such as stroke or multiple sclerosis.

Some things that increase the chance of developing incontinence:

  • Pregnancy and childbirth: This leads to stretching and weakening of the pelvic floor muscles, which can cause incontinence. Vaginal delivery, or cutting the perineum (the area between the vagina and anus) during childbirth or pregnancy, are all associated with stress incontinence.
  • overweight
  • constipation
  • Age: The older you are, the more likely you are to develop any type of incontinence.
  • Other close family members have stress incontinence.
  • Genital prolapse: This occurs when one or more pelvic organs slip oututerine prolapse From the normal position down and bulging into the vagina.

Other causes of incontinence include:

  • Urinary tract infections
  • Drink a lot of caffeine
  • pathological disorders asParkinson's disease
  • Long-term severe cough
  • Strenuous physical activity such as weightlifting

Diagnosis of enuresis in women

If you pass urine involuntarily and it bothers you or affects your daily life, you should see a doctor.
Your doctor will ask you about your symptoms and medical history. Knowing this helps your doctor know what type of incontinence you have and rule out any underlying causes. Your doctor will also ask you about any medications you may be taking.

The doctor will also do a physical exam. He will feel your abdomen and possibly do an internal exam. This means putting a finger into your vagina and asking you to squeeze your pelvic floor muscles. This can help show how well they are working.

Your doctor may ask you to write down how much urine you urinate when you go to the toilet for a few days, and whether or not you have incontinence.
It is best to record this on working and non-working days to give a complete picture.

Read on our site also about Permanent treatment of enuresis in men.

Tests to diagnose enuresis in women

Depending on your symptoms, your doctor may order a urine test to see if you have an infection or sepsis.

They may also refer you to a specialist for further tests, such as:

  • An ultrasound of your bladder after urinating
  • urodynamic tests
A woman undergoing a urodynamic and urine flow test to diagnose the presence or absence of enuresis
The doctor measures the flow and volume of urine and then inserts a catheter to find out the volume of urine remaining in the bladder

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Urinary incontinence treatment for women

Treatment for incontinence usually starts with the least invasive treatments first. This means trying lifestyle changes, in addition to other therapies, before considering surgery. The treatment you need depends on the type of incontinence you have.

There are three main treatments for stress incontinence:

Kegel exercises for women to treat incontinence

The pelvic floor muscles help control the bladder and bowels. Strengthening these muscles with the use of these exercises can sometimes help relieve incontinence.

You will be shown how to do these exercises and will need to do them three times a day for three months to see if they help. If you have problems stretching your pelvic floor muscles, biofeedback and electrical stimulation may help.

Biofeedback is when sensors placed on your skin or in your vagina send signals to a monitor when you squeeze your pelvic floor muscles.

This can help you show how well you are doing the exercises. Electrical stimulation uses an electrical current to stimulate the pelvic floor muscles from a small electrical probe placed in the vagina.

Kegel exercises for women to treat incontinence
Kegel exercises for women to treat incontinence

Medicines for the treatment of enuresis in women

There are some medications that may help treat enuresis, but they often cause side effects and are not usually given as initial treatment. If you do not want surgery, your doctor will give you the best medication for your particular circumstances.

Urinary incontinence surgery for women

There are several surgical procedures to treat all types of incontinence, depending on the cause of the incontinence. Your doctor will often suggest surgery for enuresis if you have been through non-surgical treatments first and have been unsuccessful.

Gynecological incontinence surgery in Turkey

If less invasive treatments don't help, your doctor will refer you to a specialist to discuss surgery. The main types of incontinence surgery include:

Vaginal suspension

Vaginal hanging is a process for treating stress incontinence. Stress incontinence occurs when you urinate accidentally because you are doing something that puts extra pressure on your abdomen and bladder. The extra stress can be caused by activities such as laughing, coughing, sneezing, exercising or jumping.

Stress incontinence can occur in women due to changes in the patient's muscles and ligaments that hold the bladder and prevent urine leakage, or what is known as the pelvic floor muscles and the sphincter, which is the ring of muscle that closes the bladder.

In vaginal suspension, the surgeon lifts the neck of the bladder into the correct position and secures it in place with stitches. This helps prevent urine leakage.

Vaginal suspension works well as a long-term treatment for stress incontinence in most women. If the procedure works well, it can greatly improve your quality of life.

However, vaginal suspension may not be successful in treating incontinence in women. Full recovery from the procedure may take five weeks or longer. There is also a risk of some problems during or after the procedure.

Other surgical procedures for treating enuresis in women

  • A sling procedure where the surgeon uses a piece of your own tissue as a sling to support the urethra
  • A tape procedure where a tape-like plastic mesh is placed under the urethra as a support
  • A material such as silicone can be injected to thicken and enable the area around the urethra to help it remain closed
  • Using an artificial sphincter is an option that's only used if other treatments haven't worked
A thickening material such as silicone is injected to keep the urinary tract closed
Thickening the area around the urethra to help keep it closed

What happens during a vaginal suspension?

You can have a vaginal hold as an open surgery or a keyhole (laparoscopic) surgery. Most women undergo open surgery because laparoscopic surgery is not available in all hospitals.

If you had open surgery, the surgeon will make a cut in your lower abdomen to allow access to your bladder. The cut is usually very low.

The surgeon will lift the bladder neck by suturing the top of the vagina with tissue at the back of the pubic bone. The surgeon may then place a small camera inside your bladder to check that the sutures are in the correct place and that there are no injuries to your bladder.

What to expect after vaginal suspension?

You will need to rest until the effects of the anesthesia wear off, and there are medications available to relieve any pain or discomfort you may be having.

If you had open surgery, you may have a tube (catheter) inside your bladder when you wake up, which is responsible for draining urine from the bladder into an external bag.

Or the nurses may teach you how to do a self-catheterization. This is when a disposable catheter is inserted and then removed every time you need to empty your bladder. If you need to do this, it's usually only for a few days.

After the operation, you may have a drain, which is tubes that run from the wound into a bag or bottle on the first day, where they draw out any blood or fluids.

It is important not to become constipated, as post-operative pressure can put pressure on the wound, causing pain.

Healing from the suspension of the vagina

You will likely be able to return to your usual activities after about four weeks, and for some women it may take longer than this. You may recover more quickly if you have laparoscopic (keyhole) surgery rather than open surgery.

It is best not to have sex, exercise, or lift anything heavy for six to eight weeks after the operation.

Your wound may be uncomfortable for up to six weeks after the operation. If you need pain relief, you can take painkillers such as ibuprofen or paracetamol.

Complications of vaginal suspension

Most women recover well after the vaginal suspension procedure. However, it does not necessarily work for every woman and some women may continue to suffer from incontinence after the procedure.

Possible complications include:

  • Infection, which can be in the wound, inside the pelvis, or a urinary tract infection
  • bleeding
  • urination problems
  • Overactive bladder (the patient may need to urinate often and urgently)
  • Damage to the urethra or bladder
  • Genital prolapse, where part of the uterus moves downward, causing a bulge in the vaginal wall
  • Pain during intercourse

Treatment of nocturnal enuresis in women

There are many things you can do to help Treatment of nocturnal enuresis in womenYour doctor may suggest some of the following:

  • Cut back on caffeine
  • Weight loss If you are obese
  • Change the amount of fluids you drink each day
  • Treating any constipation means eating more fruits and vegetables and drinking plenty of fluids
  • Doing less strenuous exercises

You may also find it helpful to use incontinence products, for example:

  • Wear pads in your underwear to absorb any leakage.
  • Use a portable urinal.
  • Use devices that you insert into the urethra or vagina to prevent leaks (they can't be used all the time, but may help temporarily in some situations, such as during exercise).
  • Learn self-catheterization (this involves inserting a thin, flexible tube into your urethra to drain urine when needed, if this is an option for you, your incontinence specialist will teach you how to do it).

In the end, we find that incontinence in women or lack of control over urine in women has negative effects on the psyche and life of the patient, so you should not be ashamed of this problem and see a doctor about it to be relieved of this problem once and for all.


Sources:

  1. Women's Health Organization
  2. AAFP
  3. Bupa

Frequently Asked Questions:

Pelvic floor exercises, known as Kegel exercises, help to strengthen the pelvic floor muscles. These muscles in the lower abdomen support the bladder, uterus, and bowels. Regular exercises of the pelvic floor muscles may help stop urine leakage when you cough, laugh, or do hard work.
It's important to make sure you're doing Kegel exercises the right way. This is how to do pelvic floor exercises correctly:
1. Get into a comfortable position, either lying on your back or sitting upright on a chair.
2. Imagine that you are trying to stop yourself from passing wind or urinating. You should feel pressure from inside your body.
3. Squeeze for 10 seconds as hard as you can, repeat 10 times.

Do the exercises three times a day, breathe normally while performing the exercises, you may get results within 3-5 months.
Once you see the results, continue to do the exercises once a day. Losing weight makes pelvic floor exercises more successful, but if you undergo vaginal suspension surgery, sudden weight changes should be avoided afterwards, as it affects the subtle adjustments made by the surgeon.

As we mentioned earlier, there are many treatments available for the problem of urinary incontinence in women, including conservative, some of which are medicinal or surgical, such as vaginal suspension.

Results from long-term studies of vaginal suspension have shown a high success rate of 81%, a higher recovery rate and lower postoperative complications associated with appropriate patient selection for the appropriate procedure.
For some women this procedure may not be effective so your surgeon may suggest other options such as an operation to place a sling from the patient's tissue, use an artificial sphincter to close the bladder, or you may be given a silicone injection into the (urethra) to prevent leaks.

There are several reasons for not controlling urine in women (female enuresis), including:

  • Pregnancy and Birth
  • overweight
  • constipation
  • getting old
  • Other close family members with stress incontinence
  • Genital prolapse
  • Urinary tract infections
  • Drink a lot of caffeine
  • pathological disorders asParkinson's disease
  • Long-term severe cough
  • Strenuous physical activity such as weightlifting

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