Incontinence is the inability to control flatulence, urinary incontinence or defecation and is experienced involuntarily. The severity of the disease can range from mild difficulty in controlling flatulence to incontinence of urine or feces. However, although fecal incontinence is common in this condition, many people do not disclose it because of embarrassment. This condition can occur in both men and women and may increase with age.
Urinary incontinence, which negatively affects people's quality of life, is a treatable condition. This condition, which can cause people to lack self-confidence and avoid sexual activities, also causes problems in daily life.
Birth Trauma Cause Incontinence
There are many causes of the disease. Birth trauma is one of the most common causes. These traumas can cause the muscles in the anal area to tear and reduce muscle strength. The nerves that support the anal muscles can also be damaged.
Some of the wounds that occur after childbirth may be noticeable, while others may not be noticeable and may not cause any problems for a long time. In these circumstances, childbirth may not be seen as a cause of incontinence.
Anal area surgeries or trauma to the tissues surrounding the anal area can also cause damage to the anal muscles in similar situations, making fecal control difficult. Infections around the anal area can also damage the muscle tissue and cause discomfort.
Depending on the advancement of age, weakening and weakening of the anal muscles may occur. However, it is not a problem seen only due to aging. It does not necessarily occur in every elderly person.
What are the Types of Incontinence?
Stress Incontinence
Incontinence can occur when there is pressure and contractions in the lower abdominal muscles. These pressures can include coughing, laughing and lifting something heavy. Stress is often observed when the pelvic muscles are weakened and is more common in women. It can occur when women are giving birth or during a person's surgery.
Urge Incontinence
It is experienced when the person has a sudden urge to go to the toilet. Involuntary urinary incontinence may occur in cases of feeling of squeezing. When the desire to go to the toilet occurs, urinary incontinence is very common in this type. It is related to the bladder muscles being too active and sensitive.
Overflow Incontinence
In this type, there is a small amount of uncontrollable discharge from the urinary tract. It is caused by an overfilled bladder. After urinating, the individual may feel that the bladder is not empty and have difficulty urinating again. It usually occurs in men and may be caused by a condition that interferes with the flow of urine, such as an enlarged prostate gland or tumor. It can also be caused by taking medication for diabetes.
Mix Type Incontinence
These are situations where the types of compression and stress are experienced on people at the same time.
Who Has Incontinence?
Depending on many researches and examinations, it has been reported that it is more common in female individuals than in men. In women, where this situation is experienced approximately 3 and 4 times more, the incidence progresses equally for both sexes depending on the advancement of age.
Among the answers to the question "Who suffers from incontinence?", while it can also be seen in young individuals, this rate is approximately 15 and 20 percent. For the middle age group, this situation increases up to 20 and 30 percent, while it is a rate that increases up to 50 percent in advanced ages and old age.
It is much more likely to be seen especially in women during menopause and in people who have experienced many births.
How is incontinence diagnosed?
The diagnosis of incontinence is understood by the evaluation of the patient by a specialist doctor and some tests performed. Patients should come to the examination with a full bladder. The patient may be asked for reactions such as coughing and straining. This is done to test for urinary incontinence.
The bladder is then emptied and the amount of urine left behind is determined and a gynecological examination is performed. In this way, it is determined whether there is any prolapse in the bladder, vagina and nearby organs. In addition, the pelvic floor muscles that enable the patient to hold urine are also evaluated.
In addition, some tests and examinations are also performed to diagnose and detect the disease.
A urine test is taken from the person and it is determined whether there are conditions such as blood and stones in the urine.
Blood tests are also performed on people with diabetes or other chronic conditions.
Ultrasonography can be performed to examine findings such as sand, stones and tumors that may occur in the bladder or kidneys.
In some cases, psychological tests can be applied to the person and it is determined whether the condition is psychological or not.
A urodynamic test can be performed to measure bladder pressure and determine the condition during urination or rest.
Incontinence (urine leakage) Treatment
While incontinence treatment may vary depending on the type, type, severity and accompanying pelvic relaxation, it may vary according to the person's disease history, previous surgery and age. The treatment process is planned by taking these situations into consideration.
Urinary incontinence treatment is performed with two approaches: surgical and non-surgical methods. These methods are preferred depending on the risk of the disease and the complaints of the person.
The absence of complaints and improvements in symptoms cause non-surgical treatment options to be the first choice, especially for the stress-related disease. Non-surgical treatment options of the disease can be listed as follows:
- Bladder training
- Pelvic floor and kegel exercises
- Biofeedback
- Electrical stimulation
- Vaginal and urethral instruments
- Medication
- Acupuncture
In bladder training, people are told not to go to the toilet immediately after urination and to wait. The aim in this case is to extend the interval between urination by 2 to 3 hours. It is also recommended that they go to the toilet again immediately after urinating. In this way, a complete emptying of the bladder is aimed.
Kegel exercises in pelvic floor exercises help to strengthen the area and prevent situations such as urinary incontinence.
Some changes can also be made in the person's eating habits and lifestyle. People who should avoid alcohol, coffee and acidic drinks should lose weight and do regular sports.
In addition, the person is prescribed medications that are deemed necessary and recommended by specialist doctors in order to prevent this condition. Depending on the condition of the disease, complaints and the age of the person, there may be differences in drug treatment. For this reason, people should see a doctor and have the necessary controls in case of symptoms of the disease.
In addition, in cases where the disease cannot be treated with the above methods, it can also be treated with surgical methods performed by specialist doctors and physicians. Surgical treatment methods are as follows:
- Sling Methods
- Suspension of the bladder neck
- Prolapse surgeries
- Artificial sphincter procedure
In addition, 2 surgical methods are frequently performed in stress type. These are TOT and TVT surgical operations.
TOT is the normalization of the bladder neck and urethra by suspending them with synthetic materials.
In TVT surgery, a small incision is made in the vaginal tract and the bladder neck and urethra are suspended. All 2 surgical interventions are performed with the same method and the possibility of recovery is high. It is an operation that takes about half an hour and patients can be discharged on the same day.