Article by Kostas Efstathiou, Scientific Director of the Urology Clinic of the nursing unit “ANASSA General Clinic”
Urinary incontinence is the general term that describes the involuntary loss of urine from the urethra. It is a very disturbing condition that adversely affects the quality of life, the way we move, think, work as well as our sex life. All this can lead to isolation and even depression. Urinary incontinence concerns more and more people today. According to statistics, more than 50 million European citizens face this problem. Women have more than twice the risk of developing the disease, with rates increasing with age. In Greece, it is estimated that over one million people, of which 600,000 are women, have an incontinence problem. It is estimated that approximately 15% of women under 60 and 35% over 60 suffer from the problem.
Unfortunately, incontinence is a taboo subject that patients are reluctant to discuss even with their doctor. The myth that urinary incontinence comes with age and cannot be fixed has been scientifically debunked. Modern surgical urology promises a permanent solution to the problem of urinary incontinence, both in women and men, in a percentage that exceeds 90%.
Where does incontinence come from?
Incontinence can be congenital and present during childhood. In adulthood, it is the result of some damage or illness, caused at some stage of age. It can be due to a bladder dysfunction or a deficiency of the sphincter, which is responsible for holding urine, or the muscles of the pelvic floor, as well as a combined damage of the above.
Common aggravating factors for incontinence are changes in the anatomy of the urinary tract, the muscles or nerves that control these muscles. Women can contribute to these changes:
• pregnancy
• obesity
• childbirth,
• prolapse of the uterus,
• the cystocele,
• rectal hernia,
• the menopause
• chronic constipation
• the chronic cough (smokers)
For men, operations on the prostate to treat cancer – prostatectomy – are an aggravating factor.
How many types of incontinence are there :
Stress incontinence:
In this type, incontinence occurs during exertion, such as coughing, sneezing, dancing, lifting weights, exercising, laughing loudly.
Urge incontinence:
It is incontinence that occurs suddenly with a strong and urgent need to urinate that cannot be postponed.
It may be due to:
• urinary tract infection,
•lithiasis of the urinary bladder
• neurological diseases such as multiple sclerosis,
•traumatic spinal cord injuries,
•malignant neoplasms of the bladder,
•prostatic hyperplasia,
•prostate cancer
Mixed incontinence:
Where the above two types coexist.
Resistance from overflow :
It occurs from overdistention of the bladder from urine and overflow
Treatment of incontinence:
Conservative treatment includes:
• Change in daily lifestyle by reducing body weight and stopping it
smoking
• The implementation of pelvic floor exercises with special exercises.
• Electrical stimulation of the pelvic floor muscles with special devices electrostimulation
• The use of pharmaceutical preparations
• The use of hormonal preparations (estrogens) and b-stimulators in
postmenopausal women,
The surgical treatment of female incontinence can be done by:
• False post according to Burch
• Placement of collagen or other biological bulking agents
• Placement of tension free vaginal tape (TVT,TOT,TVOT)
Surgical treatment of male urinary incontinence :
• Free tension tape (Male Sling)
• Artificial sphincter
Incontinence can negatively affect the daily life of the sufferer and degrade their quality of life. The impact on his sex life is not great either.
The Surgical Treatment of the problem is now completely safe, minimally invasive, bloodless with a short hospitalization of one day and without affecting the sexual satisfaction of both women and men.