Incontinence

Incontinence is any loss of urine, without the patient’s will.

It is a very common problem, since it affects 20-30% of the general population. It is more common in women, while in men the rates vary between 3 and 10% with the highest rates after the age of 60.In women, it occurs in small percentages in the first years of life, an exacerbation is observed during menopause, and then it increases steadily so that at the age of over 60, almost one in two women suffers.

Types of incontinence, when do they appear, how do they differ?

There are different types of incontinence, urge incontinence, stress incontinence, mixed incontinence and overflow incontinence.

• Urge incontinence often accompanies compulsion. The patient must urgently seek a toilet, wherever he is, because otherwise he will have a loss of urine. He is forced, for example, to interrupt work, travel, to urgently leave the cinema or the theater in search of a toilet. Usually, those suffering from urge incontinence know where the toilets are in the areas they frequent (they even know which ones are clean).
• Stress incontinence (also called stress incontinence) is almost a prerogative of women. It is called the loss of urine, which occurs with coughing, laughing, dancing, climbing stairs, sex and many other stressful situations (lifting weights, vigorous exercise etc.).
• In mixed incontinence, both types mentioned above coexist in the same patient.

Overfilling incontinence is the frequent loss of urine from a bladder that never empties.It is usually the result of problems (eg neglected prostatic hypertrophy, neurological diseases and injuries) that significantly and for a long time prevent the exit of urine from the bladder.

DISEASES

Diseases that affect urination and create incontinence.

Many medical conditions can affect urination and lead to incontinence.

Regarding the urinary system, incontinence results from functional disorders of the bladder or urethral sphincter (insufficiency) or from a combination thereof. Various diseases such as Spinal Cord Injuries, Vascular Strokes, Parkinson’s Disease, Multiple Sclerosis, Diabetes Mellitus, the long-term neglected urinary difficulty observed in prostate hypertrophy, etc.

TREATMENT

What are the methods of treating incontinence in men (invasive and non-invasive)

Incontinence in men is less common than in women. It is usually due to neurological diseases or prostate operations (very rarely for prostatic hypertrophy, and more often occurs after radical prostatectomy for prostate cancer). Also less often, it can be one of the symptoms of prostatic hypertrophy (benign condition) after the age of 60. The treatment depends on the cause that causes it.

If it is stress incontinence and the loss of urine is small, then an effort can be made with special exercises to strengthen the muscles of the area (Kegel exercises), if the incontinence is moderate or large, then it is treated surgically with the placement of an artificial clamp. If it is smaller, it is possible to place a special “tape” in a minimally invasive way, which can provide a solution.

When incontinence is due to a neurogenic cyst, it is usually treated with antimuscarinic drugs or with antimuscarinics and intermittent catheterizations, with botox and less often with more complex minimally invasive methods (implantation of a neurostimulator), or with various surgical procedures (eg capacity-enhancing cystoplasty of the bladder).

Methods of dealing with incontinence in women (invasive and non-invasive)

The method of treating incontinence in women depends on the type of incontinence.

Urge incontinence is treated with modern antimuscarinic drugs, usually supplemented with bladder retraining and behavior modification measures, which have very good results in a large proportion of patients. If they fail, an intravesical injection of botulinum toxin can be done, while very rarely surgical manipulations are required, when there is no response to the above-mentioned conservative treatments.

Stress incontinence is usually treated surgically. Placing a free-tension vaginal “tape” is a short-term operation that has very good results. In more complex cases, there are a number of other operations that can solve the problem. In small urine loss, various special exercises (such as Kegel exercises) are initially recommended which may have satisfactory results.