Types of urinary incontinence
Correctly determining the type of incontinence is the basis of treatment, because the approaches are fundamentally different. Exercises and surgery help with one type but are useless with others.
- Stress incontinence - leakage when coughing, sneezing, laughing, lifting heavy objects, running; there is no urge. The reason is the weakening of the supporting apparatus of the urethra
- Urge incontinence - leakage due to a sudden, irresistible urge; often accompanied by frequent urination and getting up at night. The cause is excessive activity of the bladder muscle
- Mixed incontinence is a combination of the two previous types; occurs very often
- Overflow incontinence - constant dripping when the bladder is full and cannot empty; typical for men with prostate adenoma and neurogenic disorders
- Persistent incontinence - continuous leakage, characteristic of urinary fistulas after surgery or childbirth
- Functional incontinence - when the bladder is healthy, but the person does not have time to get to the toilet due to mobility or cognitive impairment
Causes and risk factors
- Pregnancy and childbirth, especially with a large fetus or with perineal ruptures
- Menopause and decreased estrogen levels leading to thinning tissue
- Age-related weakening of the pelvic floor muscles
- Obesity - constant increase in intra-abdominal pressure
- Chronic cough in smokers and lung diseases
- Chronic constipation and straining
- Heavy physical labor, heavy lifting
- Surgeries on the pelvic organs, in men - prostate surgeries
- Neurological diseases: stroke, multiple sclerosis, Parkinson's disease, spinal cord injury
- Diabetes mellitus
- Urinary tract infections - cause temporary incontinence
- Taking certain medications, including diuretics and sedatives
Diagnostics
- Detailed survey: when, under what circumstances and to what extent does leakage occur?
- Diary of urination for 2–3 days, taking into account the volume of liquid drunk and episodes of leakage
- Cough test and straining test
- Pad test for objective assessment of urine loss volume
- Gynecological examination in women - assessment of pelvic organ prolapse and mucosal condition
- Ultrasound of the bladder with determination of residual urine
- General analysis and urine culture
- Uroflowmetry
- Complex urodynamic study - for mixed, complex and recurrent forms
- In men - prostate assessment, PSA, uroflowmetry
A simple guideline that helps already at the first appointment: if urine is lost during coughing and physical effort without urge, this is a stress component; if it gets lost against the background of a sharp unbearable urge - urgent.
Conservative treatment
- Exercises for the pelvic floor muscles (Kegel exercises) are the basis for the treatment of mild to moderate stress incontinence; require regularity over several months
- Biofeedback and electrical stimulation to teach proper muscle function
- Scheduled bladder training for urge incontinence
- Weight loss – significantly reduces episodes of leakage
- Correction of drinking regime, limiting caffeine, carbonated drinks and alcohol
- Treatment of constipation and chronic cough
- Drugs that reduce bladder activity - in urgent form
- Local estrogen therapy in menopausal women as prescribed by a gynecologist
- Pessaries and urological inserts as aids
Surgical treatment
The operation is indicated for moderate to severe stress incontinence, as well as when conservative methods have failed.
- TVT sling operation and its modifications - a synthetic loop is installed under the middle part of the urethra, creating support when intra-abdominal pressure increases; minimally invasive intervention with short recovery and high efficiency
- Sling surgery with Promedon sling and other systems
- The introduction of a volume-forming gel into the area of the bladder neck is a low-traumatic method, suitable for patients with contraindications to surgery
- Cystopexy - surgery for severe prolapse of the bladder
- Botulinum toxin therapy for the bladder - for drug-resistant urge incontinence
- Correction of urinary fistulas with persistent incontinence
- For men after prostate surgery - special male slings and an artificial sphincter
What you can do on your own right now
- Начать регулярно выполнять упражнения для мышц тазового дна, освоив правильную технику
- Вести дневник мочеиспусканий — он понадобится врачу и сам по себе помогает увидеть закономерности
- Снизить вес при его избытке
- Сократить кофе, крепкий чай, газированные напитки и алкоголь
- Не ограничивать питьё резко: концентрированная моча сильнее раздражает пузырь и усиливает позывы
- Наладить работу кишечника
- Отказаться от курения, если есть хронический кашель
Where is urinary incontinence treated in Tashkent
To choose the right treatment, you need a urologist who knows how to diagnose types of incontinence, ultrasound, urodynamic examination for complex forms, and the ability to perform sling surgery.
In Tashkent, examination and treatment of urinary incontinence, including sling operations and the introduction of a volume-forming gel, is carried out at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic.
Before your appointment, fill out a urination diary for two to three days - this will significantly speed up the diagnosis and make the first consultation much more meaningful. Clinic contacts and registration are below.
