How Is Incontinence Treated? – Dr. A. Kadir Tepeler, MD


Urinary incontinence, known as urinary incontinence in medical language, is a health problem that develops in people of all age groups. Urinary incontinence, which is defined as involuntary and uncontrollable urination, affects social and personal life very badly.

Urinary incontinence due to overfilling of the bladder reduces the quality of life and causes psychological problems. So how is the diagnosis and treatment of urinary incontinence?


The bladder in which the urine produced in the kidneys is collected is called the bladder. Contraction and relaxation movements in bladder muscles are under the control of regional nerves and brain. The bladder, which normally contains urine, stretches and balances its internal pressure. In this way, the valve that opens out of the bladder is kept closed.

The urethra is the channel that comes after the bladder, and the urethra is controlled by the hormones secreted and the nervous system. In the case of urinary incontinence, the pressure in the overfilled bladder also increases rapidly and exceeds the urethral pressure. In this case, urine overflows out of the body through the channels. Urinary incontinence can be seen in everyone and is divided into 3 types in itself:

  • Stress Type: Situations that increase pressure in the urinary bladder, such as laughing, coughing, sneezing, and carrying heavy loads, cause urinary incontinence. This condition is caused by weakness in the nervous and muscular systems.
  • Urge Type: It develops into a sudden urge to urinate and involuntary urinary incontinence. In this case, uncontrollable contractions occur in the bladder. The reason is variable.
  • Mix Type: It is the situation where both stress and compression are present at the same time.

Who Gets Urinary Incontinence?

Urinary incontinence can be seen in both men and women, but it is more common in the elderly and women.

Approximately 25% of women aged 60 and over experience daily or weekly urinary incontinence.

The annual cost is quite high in these people and if regular care is not taken, more serious complications such as ulcers on the skin may develop.

It can be seen in men in conditions that impair smooth muscle functions or after surgical treatment.

Transient urinary incontinence is a very common problem in the elderly. Many things can cause this condition, including infection, inflammation, psychological factors, limited movement, and heart failure. Urge incontinence is one of the most common problems among the elderly.

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What Causes Incontinence?

Urinary incontinence can occur due to many physical and psychological reasons. The most common causes are:


  • Senile
  • Obesity
  • Genetic factors
  • Sagging in the bladder
  • Stone formation in the urinary tract and kidneys
  • Prolonged constipation
  • Cystitis
  • Diabetes
  • Difficult giving birth
  • Menopause
  • Vaginal infections
  • Fistula formation between vagina and bladder
  • Enlargement of the prostate in men - surgical treatments (such as radical prostatectomy - cystectomy, prostate surgeries)
  • Alzheimer's
  • Nervous system diseases
  • Use of diuretic, blood pressure lowering, muscle relaxant drugs
  • Psychological factors

How Is Incontinence Treated?

In the treatment of urinary incontinence, the patient's history and general health are very important. Conditions that cause urinary incontinence are effective in understanding the type of disease. For this, tests such as urinalysis, blood test and ultrasound are applied. Depending on the condition that causes urinary incontinence, the treatment method may vary.

In overweight patients, the priority is to lose weight by applying a diet and exercise program. In cases that occur due to constipation, a more regular and healthy diet is made, and drug treatment is also applied. In the presence of uncontrolled diabetes, an additional nutrition program is prescribed to drug treatment. As a precaution, excessive fluid intake is avoided. Alcohol and smoking are discontinued.

Antibiotic treatment is essential in cases resulting from urinary tract infections. Some patients are also recommended exercises to strengthen the pelvic and bladder muscles. With these exercises, it is possible to control the retention and release of urine.

If necessary, urologists can switch to drug therapy for urinary incontinence. Surgical operation may be required in case of urinary incontinence caused by conditions such as prostate enlargement and bladder prolapse. Untreated urinary incontinence can lead to more serious diseases in the future. For this reason, a specialist should be consulted as soon as possible after the symptoms appear. The most appropriate treatment method is applied to the patient with the patient's history and detailed physical examination.

In mild stress urinary incontinence, the underlying causes are corrected and pelvic muscle strength is tried to be increased with exercises. In some patients, drug therapy may be added to the treatment. Surgical treatment is applied in patients with severe stress urinary incontinence that impairs their quality of life. For this purpose, middle urethra sling operations (TOT, TVT, mini siling) are applied. If patients have accompanying cystocele, rectocele or prolapse, it can be applied in the same session.

Lifestyle changes are recommended at the first stage in urge urinary incontinence. In addition, anti-muscarinic drugs are started. Botox injection into the bladder is applied to patients who do not benefit from these drugs or cannot use them due to their side effects.

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