What Is Urinary Incontinence and How Is It Diagnosed?
Urinary incontinence is the involuntary leakage of urine during daily activities. It affects about 15–20% of women over their lifetime and is a treatable condition. Although many believe it to be a natural consequence of aging, urinary incontinence is not an inevitable part of getting older.
In women, it may occur at different ages for different reasons. Sometimes it is triggered by activities that increase abdominal pressure, such as exercise, coughing, sneezing, or sudden movements. In other cases, women may leak urine before reaching the bathroom after a sudden urge to urinate. This condition can lead to withdrawal from social life, reduced quality of daily living, and loss of self-confidence. Consulting with experienced specialists, such as Arda Lembet and his team, helps ensure an accurate diagnosis and a personalized treatment plan.
Diagnosis begins with a detailed medical history and pelvic examination. Additional tests may include urinalysis and urodynamics. Urodynamics is an advanced test that evaluates bladder function and muscle control. In modern clinics, simpler diagnostic devices that can be used comfortably during examination are also available.
Types of Urinary Incontinence
- Stress Incontinence is the most common type. Leakage occurs when intra-abdominal pressure increases (laughing, coughing, lifting). It is usually caused by weakness of the pelvic floor muscles or failure of the internal sphincter. Risk factors include multiple vaginal births, delivering large babies, menopause, and obesity.
- Urge Incontinence (Overactive Bladder) involves a sudden, strong urge to urinate followed by leakage before reaching the toilet. It is caused by uncontrolled bladder muscle contractions.
- Mixed Incontinence is a combination of stress and urge incontinence.
- Overflow Incontinence occurs when the bladder becomes overly full, leading to dribbling. Patients often feel unable to empty their bladder completely. Causes may include diabetes, spinal cord injury, or major pelvic surgeries.
Treatment Options for Urinary Incontinence
Urinary incontinence can be treated at any age. The approach depends on the type and underlying cause.
- Behavioral and Muscle-Strengthening Therapies are the first step. Pelvic floor (Kegel) exercises strengthen the muscles and improve control. Keeping a bladder diary helps structure a personalized program. Biofeedback devices and electrical stimulation may be added for support. These methods are non-invasive but may not fully resolve symptoms in every patient.
- Medication is particularly effective for urge incontinence. Drugs that suppress bladder overactivity may be prescribed. In stress incontinence, medications are usually less effective, though local estrogen creams or patches may help some patients.
- Surgical Treatment is considered when conservative methods are insufficient. Options include:
- Sling procedures (TVT, TOT)
- Retropubic suspension (Burch procedure)
- Needle suspension techniques
- Periurethral injections (such as Teflon or silicone fillers)
Surgical approaches aim to strengthen urethral support and provide a lasting solution to urinary leakage.
