Women’s urinary incontinence
Daily, dozens of women experience intense anxiety about their social life and their hygiene in connection with urinary incontinence, which arises as a very delicate and prominent research topic for the medical world and more.
Especially if we take into account that the number of women experiencing urinary incontinence is way too big (13 million women in the United States, and according to a recent study in Greece 3 out of 10 women struggle with some kind of incontinence), raising awareness and striving for immediate solutions, is of significant priority to all individuals involved in healthcare profession.
Unfortunately, urinary incontinence in women may afflict much young women than most people believe, because it isn’t always a condition having to do with age.
So, while it is becoming more and more common, and at the same time torturing very young women who are professionally and personally very active, it is those women who avoid discussing the problem even with their own doctor.
As a result, they themselves put obstacles in their everyday routine, deteriorating their social life and avoiding activities which improve their quality of life, such as entertainment, exercise, sexual activity etc, which may lead to social isolation and possibly depression.
This is a huge mistake, that women must stop making to themselves, reaching for immediate solution which, nowadays , is not a myth but a reality. How is this possible in the most simple way?
By merely having a discussion with a gynecologist, who will direct any individual to the proper diagnosis. Identifying the problem may be the most important stage in order to reach the most accurate and appropriate solution.
We should take into consideration that urinary incontinence is a symptom, which differs from case to case, but also a rationale, so it is necessary to go through all of the above in order to understand the treatment a woman may need, according to what type of urinary incontinence she is dealing with.
For a better perception of this topic, it would be useful to mention that according to clinical description, the commonest types of urinary incontinence, are the following:
- urinary incontinence which simply appears when we put pressure in our abdominal area through coughing, laughing, sneezing, weightlifting or exercising. It is the commonest type, usually met in younger women.
- urinary incontinence of imperative type, which is the immediate and sudden need to urinate, followed by urine loss.
- mixed type, when both of the above are met
- urinary incontinence due to overfilling
- constant incontinence due to anatomic malfunction or permanent neurologic causes.
All of the above types are also treated in a quite different way, also depending on the grade of the issue, therefore it is of utmost importance to have the appropriate diagnosis. In order to achieve this, we have a special examination called Urodynamic control, taking place in specialized centers after taking history of the symptoms, clinical evaluation and a simple urine test and culture.
It is a very simple, no pain test, where we place a very thin, tiny catheter and, assisted by a computer, we study the activity of the bladder and the urethra and we determine the root of the problem extremely precisely.
So after your doctor defines with much certainty and precision the type and the grade of incontinence, he will choose, according to each case, the treatment that must be followed.
In the last decade the choices in treatment, especially to cases that have to do with effort- which also happens to be the biggest percentage, gave very high percentages of effectiveness in treatment (90%), with very easy techniques , which led to more and more women finding a permanent solution.
A technique chosen quite often in cases of incontinence, due to medium or big effort, is putting a vaginal tape under the urethra, which supports the effort of the sphincter muscle to hold back the urine coming out unintentionally, when there is bigger endoabdomen pressure, through coughing, laughing and weightlifting.
The big advantages of this technique, are that it doesn’t need general anesthesia, it takes around 15 to 20 minutes, it doesn’t need stay in hospital, there are no particular complications and we have great effectiveness.
Another very important point is that this technique may successfully be combined with other procedures connected to vaginal looseness, uterine prolapse, cystocele, so we can achieve even better results.
Another very contemporary and effective technique for treating urinary incompetence is laser . Painless, simple, short, complication free, it is an excellent alternative therapy in some cases, if evaluated so by the expert.
In most cases, when conservative treatment is advisable, and not surgical treatment, we have new, enhanced options, such as new medicines with less side effects and better results, or advanced forms of exercises for the area, in order to improve the symptoms.
As a result, there is a solution and it’s not a myth but a reality, as long as you get the courage to talk your problem through with your doctor or address to a specialized urinary incontinence clinic.
PELVIC FLOOR RELAXATION
Stress. Daily, relentless strive for success. Pressure to be a good mother, a good wife, a good partner, a housewife, a successful professional. This is the definition of contemporary women, diffused among such demanding roles, quite often neglecting personal issues of vital importance.
The burden of accomplishing daily duties takes its toll, not only by diminishing good health but also affecting sexual life. Issues like the good condition of genitals, especially the vagina, while worrying thousands of women daily, only few finally find the courage to seek a solution.
Vagina looseness and prolapse of pelvic organs (uterus, vagina, bladder) are clinical issues, causing a variety of symptoms and irritations, such as pain in the lower abdomen area, a sence of weight, acute cystitis, constipation, even avoiding sexual intercourse. Usually women who are presented with such issues, are the ones who have had a vaginal labor, and these symptoms are usually getting worse with menopause, putting on weight and chronic coughing.
As specialists, when we approach such an issue, we ought to be as up -to- date as possible, in order to be able to offer the most contemporary, scientifically proven, appropriate treatment.
The big development and evolution of biotechnology enables us to use new material and advanced, minimally invasive techniques to perform surgeries, raising the expectancies of women to obtain a better life quality.
Doctors who are involved in urine gynecology, are now able to offer women contemporary treatment, advanced and of minimum pain.
Common operational procedures to restore such disorders, are known as colporaphy, simply being plastic surgeries of the vagina aiming at the anatomical correction and support of loose organs. These procedures have evolved, with more contemporary techniques and by using special nets. These nets are made with special synthetic material and may remain inside the human body for life.
The most important advantages of the new techniques combined with nets, are the diminished possibility of relapse, something quite common after common colporaphy. Simultaneously, we achieve a better anatomical support and tissue correction, better sex life, very few days in hospital and quick recovery.
As a doctor, specialized in such delicate matters, I strongly advise all women facing such issues,to immediately seek the quality of life they used to enjoy before, because today, there is a solution, and it’s quite effective, fast and easy.
BLADDER INFECTION- WHAT MUST I KNOW?
It is one of the most common infections for women and its symptoms are acute and annoying.
From the moment when a woman becomes sexually active, her urinary system can easily be infected by germs causing infections and inflammations.
WHY IS THIS HAPPENING?
- Inside the vagina there are a number of germs which, during sexual intercourse, are easily inserted into the cyst through the urethra.
- weak immune system
- systemic diseases like diabetes and menopause make the area much more sensitive to wounding and developing germs, due to the acute atrophy caused by lack of estrogens.
- anatomical or functional pathological situations around the pelvic area, such as: cystocele, uterine prolapse, urethra diversions, cystic diversions etc.
WHAT ARE THE SYMPTOMS?
Usually discomfort begins with frequent urination, strong pain, immediate need to urinate followed with very little urine quantity, strong feeling of burn during urination and finally hematuria.
In heavier situations, this infection can also attack the upper urinary system, causing fever.
Diagnosis is confirmed with general urine examination and urine culture.
Frequency matters!!
In cases of common infections, it is necessary to perform further and more thorough tests, such as:
- ultrasound of the lower abdomen
- check up for kidney stones
- urodynamic checkup
- cystoscopy
Urinary infection is treated medically by taking antibiotics. There are, though, some tactics and simple advice that help preventing it.
SO WHAT CAN WE ADVISE WOMEN TO DO?
- urinate before and after sexual intercourse
- look after the hygiene of the area, with lots of water without using strong antiseptics
- consume big quantities of water daily
- eat dairy products, as they assist in maintaining a natural, acidic vaginal flora and also in doing away with pathogenic germs.
- women should prefer cotton underwear and avoid, as much as possible, tight trousers.
- they should also look after their immune system, which is the defense of their system, by taking vitamins, eating properly and maintaining a good mental health. Homeopathy also assists in building a good immune system.
- in women going through menopause, local estrogens should be prescribed in some cases, in order to reverse and improve the natural vagina flora.
WHAT IS URODYNAMIC CHECKUP?
It is a very important diagnostic test, which gives us plenty and very important information on the proper cystic and urethra function. It is the only test which can reliably define, according to result, the treatment of women’s urinary incontinence.
WHEN DO WE NEED TO PERFORM A URODYNAMIC CHECKUP?
The doctor will ask for the specific test, when he wants to investigate the roots of problems associated with:
- urinary loss, willingly or not
- unsatisfactory cyst evacuation
- tendency for very frequent urination
- imperative need for urination
- intermitted urination
- common relapsing urine infections
It is extremely important to mention that it is absolutely necessary, for any women undergoing a vaginal surgical procedure due to prolapse, to first be submitted to a urodynamic checkup before surgery.
HOW IS URODYNAMIC CHECKUP PERFORMED?
It is a very simple, painless test which lasts approximately 30 minutes and doesn’t need anesthesia. At first the woman must urinate in a special container, and then a catheter is put inside the cyst. Finally, another catheter is put in the anus (this being the most disturbing part of the testing).
After that, through the tiny catheter we fill up the cyst, and simultaneously with the assistance of a computer, we measure and analyze the pressures inside the system, getting a very clear evaluation of how the lower urinary system works.
Before urodynamic checkup, a few tests must also take place. These tests are, urine general test, combined with urine culture in order to exclude the possibility of an active infection, and a kidney, ureter, cyst and inner getitalia ultrasound.
Results of this checkup are immediate