Urogynecology

Types of urinary incontinence

Stress incontinence

Leakage of urine due to increased pressure in the bladder when coughing, sneezing, laughing, lifting heavy objects or other physical exertion.

Urge incontinence

Occurrence of a spontaneous, overwhelming need to urinate, followed by an involuntary discharge. Patients complain of frequent urination, including at night. Urge incontinence can occur with urinary tract infections or with more serious neurological diseases, diabetes mellitus, etc.

Overflow incontinence

It is manifested by frequent to almost continuous discharge of drops of urine, due to incomplete emptying of the bladder.

Functional incontinence

Some physical and mental illnesses can impair the ability to urinate normally, e.g. – severe arthritis, etc.

Mixed types of urinary incontinence

It is usually a combination of stress incontinence and urge incontinence.

The most common causes of urinary incontinence are:

• Obesity - causes increased tension on the bladder and surrounding muscles, which facilitates the release of urine when coughing and sneezing;
• Smoking;
• Family burden;
• Pregnancy - hormonal changes and the increasing weight of the fetus can lead to difficult retention of urine;
• Childbirth - a traumatic vaginal delivery can lead to weakening of the pelvic floor muscles, damage to the nerves of the bladder, tears in some pelvic floor muscles, which over time can lead to prolapse. Prolapse can affect individual or multiple organs in the small pelvis - bladder, uterus, rectum, etc. Often times the prolapse is combined;
• Age - with advancing age, the amount of collagen in the tissues decreases, which naturally also affects the organs in the small pelvis. Over time, the elasticity of the bladder decreases, as does its ability to hold more urine. With advancing age, urination becomes more frequent;
• Menopause - the amount of estrogen gradually decreases, which again negatively affects the tissues of the bladder and urethra;
• Pelvic tumors - some tumor formations of the organs in the pelvis (uterus, ovaries, supporting apparatus of the uterus etc.) can disrupt the function of the bladder by pressing;
• Stones that have fallen into or formed in the bladder can cause drainage disturbances, inflammatory reactions and varying degrees of pain;
• Some neurological diseases (Parkinson's disease), diabetes mellitus and others. increase the risk of urinary incontinence.

The most frequently observed complications of urinary incontinence are:

• Impaired quality of life in terms of limited social contacts, increased risk of trauma (in older patients), etc.;
• Recurrent urinary tract infections;
• Skin changes - rashes, skin infections and pain as a result of the continuous wetness.

Prevention

• Prevention of urinary incontinence is not always possible, but the risk of developing the condition is reduced by:
• Maintaining an optimal weight;
• Using certain specific exercises to tighten the pelvic floor;
• Avoiding foods and drinks, irritants to the urinary tract – caffeine-containing, alcohol, carbonated drinks, hot and highly acidic foods, large doses of vit. C, some sedatives, high blood pressure drugs, muscle relaxants;
• Eating more fiber to prevent constipation and, in the long term, urinary incontinence;
• Having some laser procedures performed at a specialized medical facility.

When to seek a professional opinion

The causes of urine incontinence can be different - traumatic birth, some daily harmful habits, some specific diseases, incl. and from psychological problems, etc. A careful and thorough examination by an Ob/Gyne specialist helps to establish the specific cause of your complaints. Sometimes the patient feels discomfort and inconvenience to share his complaints of urinary incontinence even with his doctor. When the quality of life deteriorates, it is very important that these symptoms are discussed in order to make a correct and accurate diagnosis of the condition. Although rare, in some cases there are more serious underlying problems.

For more information about the possibilities for diagnosis and treatment of your problems related to urinary incontinence you can visit and seek a professional opinion at MC MARKOVS - the modern clinic of Sofia. The center has excellently trained Ob/Gyne specialists and modern laser equipment. These are necessary prerequisites for an accurate and precise assessment of your condition and planning of correct and adequate treatment.