Urinary Incontinence in Women

Urinary incontinence, also known as involuntary urine leakage, is a very common problem that negatively affects the psychological, physical, social and financial well-being of people and their families, causes hygiene problems and lowers quality of life. It is the involuntary loss of urine and is associated with psychological stress, social isolation and depression. It reduces self-confidence, leads people to avoid sexual activity and causes problems in daily life. It can be more common in women than in men. In women, weakening of the pelvic floor muscles leads to involuntary urine leakage during activities that increase abdominal pressure, such as coughing, laughing, sneezing or exercise. The leakage may be just a few drops or enough to soak a pad.

What Causes Urinary Incontinence in Women?

Many factors cause urinary incontinence and increase its frequency. These include;

• age (although it can occur at any age, it becomes more common with advancing age)
• menopause,
• parity (number of births),
• vaginal delivery,
• obesity,
• previous pelvic surgery and previous prostate surgery
• previous hysterectomy (surgical removal of the uterus),
• weak pelvic floor muscles,
• urinary tract infection,
• prostate enlargement in men
• neurological disorders (such as stroke, dementia, MS, Parkinson’s disease or spinal cord injury)
• local irritation of the bladder by infection, stones or tumors, among many other causes

In addition, certain medications, caffeine and alcohol can increase urine output and raise the risk of incontinence.

What Are the Types of Urinary Incontinence?

There are different types of urinary incontinence depending on which part of the urinary tract is affected.

• Stress urinary incontinence (SUI): Occurs during activities.
• Urge incontinence: Occurs with a sudden, strong urge to urinate. The bladder muscle contracts and urine leaks.
• Mixed incontinence: When a person has symptoms of both urge and stress incontinence.

Can Urinary Incontinence Be Treated?

Urinary incontinence is an important health problem that patients sometimes do not take seriously and that is not asked about enough in medical practice. This delays treatment. The reason is that patients do not see a doctor and, even though it affects their comfort and quality of life, they think of it as a natural process rather than a condition. For diagnosis and treatment, doctors should ask about incontinence symptoms in all female patients who come in for any reason, at any age but especially after menopause.

Urinary incontinence is an important health problem that patients sometimes do not take seriously and that is not asked about enough in medical practice.

Diagnosis requires a medical history, physical examination (abdominal, genital, rectal and neurological examinations), laboratory tests and imaging.

When taking the patient’s medical history;

• Do you leak urine when you exercise, cough, sneeze or lift something heavy?
• Did the symptoms start after pregnancy or vaginal delivery?
• How often do you leak urine?
• How often do you go to the toilet?
• Do you wake up at night to urinate?
• When you need to go, do you have to rush to make it to the toilet in time?
• Do you feel that your bladder has not emptied after urinating?
• How much urine do you leak?
• How many pads do you change a day?
• How much does incontinence affect your daily life?
• In what situations do you leak urine?
• What medications do you take?
• Do you smoke?
• When and how much fluid do you drink?
• How much coffee and alcohol do you consume?
• Have you ever been pregnant?
• Have you gone through menopause? Questions like these should be asked.
• Have you had any surgery before?
• Do you have any problems with bowel movements?

Treatment options for urinary incontinence are;

• strengthening the pelvic floor muscles,
• medication
• surgical treatment.

As a first step in treating urinary incontinence, the following are especially recommended;

• Limiting fluids in the evening and avoiding caffeine and alcohol,
• Losing weight if the patient is obese,
• Quitting smoking
• Treating coughs and lung diseases.

Patients are also taught “Pelvic Floor Exercises (Kegel exercises)” to strengthen the pelvic floor muscles. It is recommended to do the exercises at least 30–45 times a day in different positions: lying down, sitting and standing.

Patients are asked to squeeze the muscles in the genital area as if trying to hold in urine.

Contract for 5 seconds, then relax for at least 10 seconds between contractions. If you have a urinary incontinence problem, do not hesitate to seek professional help.

Our Tips to Make Life Easier for People with Urinary Incontinence;

• Use the toilet before your bladder feels full.
• Try to empty your bladder every night before bed.
• Products such as pads and drip collectors are available to conceal urine leakage.
• Use odor neutralizers.
• Try to do pelvic floor exercises.
• When traveling, try to choose a seat near the toilet.
• Avoid drinking too much fluid during working hours.