Urinary incontinence (NTM) treatment – types. Urinary incontinence treatment methods

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Urinary incontinence is an embarrassing problem that means that some patients do not visit the doctor’s office. This is a mistake – urinary incontinence can be successfully treated both in young and old age. And the sooner a specialist finds out about the disease, the better.

What is urinary incontinence?

Urinary incontinence (NTM), or incontinence, is a condition in which you partially lose control of your bladder emptying. Unintentional, involuntary urination (micturition) affects both men and women of all ages. There are three types of this disease:

1. stress urinary incontinence,
2. urgent urinary incontinence,
3. overflow incontinence.

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Stress urinary incontinence

Stress urinary incontinence occurs when the problem occurs due to a weakening of the pelvic floor muscles that surround the urethra. Under normal, proper conditions, they help to close the coil tightly, but when excessively relaxed, voiding can occur even with a slight increase in pressure inside the abdomen, e.g. when exercising, laughing, coughing, sneezing or lifting heavy objects.

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Stress urinary incontinence most often affects women. Past pregnancies and natural births burden the neuromuscular structures of the pelvic floor, while the decrease in estrogen levels (e.g. during menopause) reduces flexibility and worsens blood supply to tissues.

When the muscles weaken and the mucosa of the urethra is too thin, urination is uncontrolled and the urethra opens even with slight pressure on the bladder. Other risk factors for stress urinary incontinence include:

1. aging of the body (this applies to both women and men),
2. obesity,
3. some gynecological treatments and diseases.

Urgent urinary incontinence

Urgent urinary incontinence, also known as reactive incontinence, results from a malfunction of the bladder. A strong urge to urinate also arises when the bladder is not full. This can happen when you change body position or during sexual intercourse.

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In this situation, it is referred to as an overactive bladder. The causes of this type of incontinence are unknown, but it is known that this problem most often affects women and men over the age of 60.

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Overflow incontinence

So-called overflow incontinence usually occurs in men with an enlarged prostate. The disease is the inability to completely empty the bladder and manifests itself by passing small amounts of urine frequently.

When the bladder becomes stretched, urine will leak out. In addition to an enlarged prostate gland, other factors that can lead to the development of overflow incontinence include:

1. hormonal disorders,
2. neurological diseases,
3. diabetes,
4. urinary tract infection,
5. chronic constipation,
6. long intake of diuretics.

Urinary incontinence – what to do?

Urinary incontinence is a disease that can strongly affect the human psyche. People with incontinence often withdraw from social or professional life, and living under constant stress and anxiety can cause depression.

It is not worth waiting for the problems to worsen, there is also no point in limiting fluid intake – contrary to appearances, it can only worsen the situation. The only good solution is to see a doctor, even if you feel embarrassed and embarrassed at first.

For women, it’s best to see a gynecologist or urogynecologist. Gentlemen with incontinence can visit a urologist.

Conservative treatment of incontinence

Before the doctor recommends the patient to appropriate therapeutic treatment, it is necessary to conduct a diagnosis. The interview may be accompanied by a urodynamic examination, coughing test, urine culture or ultrasound examination of the urinary system.

In the case of stress urinary incontinence, the specialist will suggest training the pelvic floor muscles, i.e. the Kegel muscles. If the disease is in its infancy, daily exercise may produce satisfactory results. For training, you can additionally use the so-called pessaries or vaginal cubes. Conservative treatment of urinary incontinence is further supported by pharmacology. For this purpose, it uses, among others hormonal preparations with the content of estrogens, which make the tissues more elastic.

In the case of male overflow incontinence, treatment of the prostate gland, which is sometimes responsible for the appearance of incontinence, may be of key importance. This type of disease in women is most often caused by passing water too little. This is why women are advised to change their lifestyle in the first place and visit the toilet regularly to empty their bladder.

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In the case of urgent urinary incontinence, drugs that act on the nervous system can be used – thanks to them, it is possible to reduce the feeling of pressure on the bladder. In addition, it is worth implementing bladder training, which includes, among others on passing urine at certain times and gradually increasing the intervals between visits to the toilet.

Treatment methods in the treatment of urinary incontinence

If conservative treatment does not bring the expected results, it is worth using the treatment methods. In recent years, minimally invasive laser or ultrasound (HIFU) treatments, which are used in women, have become very popular. They involve the insertion of a laser beam or a HIFU head into the vagina. The generated energy constricts the vaginal walls and increases their elasticity. This stabilizes the urethra, reducing or completely eliminating the problem of urinary incontinence. These procedures are painless and short, and you can go back to your daily activities straight away.

In patients with urgent urinary incontinence, botulinum toxin injections, i.e. botox, are also used. The substance injected into the bladder stops the malfunctioning muscles in the bladder from working properly, so that it can be restored to normal function. This method can be used on an outpatient basis, but it should be kept in mind that it needs to be repeated from time to time.

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There is also an operative method of treating urinary incontinence. Treatments with the use of TVT / TOT tapes involve the application of a special synthetic tape under the urethra. The result is its lifting and support. The tape is inserted through a small hole in the vaginal wall. The entire procedure usually takes about 30-40 minutes and usually requires one-day hospitalization.

Urinary incontinence treatment – prices

The cost of laser treatment of stress urinary incontinence is usually between PLN 800 and PLN 3500. Ultrasonic treatments (HIFU) are an average cost of about PLN 1900. The price of the operation with the use of TVT / TOT tapes can range from 2000 to 6400 PLN.