Statistics show that 50 percent of adult women experience urinary incontinence. Yeditepe University Hospitals Gynecology and Obstetrics Specialist Asst. Prof. Dr. Melis Koçer Yazıcı stated unfortunately, women are afraid to consult a doctor due to shame, lack of information about treatment options, and/or fear of surgery. In parallel with the increase in average life expectancy, this problem is predicted to increase in the coming years.

Urinary incontinence, which may be observed in women in all age groups, is deemed a serious public health issue that affects people throughout the world. The issue, which is experienced by about 50% of adult women, is observed in 25% in young women, 44-57% in middle-aged women and 75% in elderly women. Pointing out that in parallel to the increase in average life expectancy, the global economical burden of urinary incontinence will also increase, Obstetrician and Gyneacology Specialist  Dr. Melis Gökçe Koçer Yazıcı pointed out that the disorder will continue to pose a significant problem for public health.

Stating that a lot of reasons, ranging from genetical factors to obesity, diabetes to smoking, may be the reason for urinary incontinence, Dr. Melis Gökçe Koçer Yazıcı reminded that there is a strong connection between aging and disorder prevalence and its severity. Yeditepe University Hospitals Obstetrician and Gyneacology Specialist Dr. Melis Gökçe Koçer Yazıcı stated the reasons for this as follows: “In connection with the lowering estrogen levels due to aging, urinary incontinence may be caused secondarily due to the loss of elasticity in connective tissues, as well as the weakening of pelvic muscles, which function as a support, and bladder. Yet, aging by itself is not considered as an independent risk factor for urinary incontinence. Lifestyle plays a more important role”.

Pregnancy Is an Important Factor

Stating that hormonal changes during pregnancy, total weight of the baby and related organs, the increase in abdominal pressure, and the damage in pelvic nerves and muscles during childbirth may result in urinary incontinence, Dr. Melis Gökçe Koçer Yazıcı stated “In parallel with the number of pregnancies, risk also may increase. In patients who have a urinary incontinence before the pregnancy, there is no verifiable data that a C-Section birth has a preserving effect”.

Excess Weight Increases the Risk

Stating that there is a strong connection between urinary inconstinence and lifestyle, as well as nutrition habits, Dr. Melis Gökçe Koçer Yazıcı stated “Excess weight, chronical constipation, smoking – alcohol use, use of caffeinated beverages, chocolates, candies or asidic foods and beverages are among risk factors. Also, the first method to apply in cases of urinary inconstinence following the evaluation is changing the lifestyle”.

Pointing out that obese women are three times more likely to experience the disorder, Dr. Melis Gökçe Koçer Yazıcı continued as follows: “While its relationship mechanism with urinary inconstinence is unknown, excess weight is thought to increase the abdominal pressure and in turn lead to urinary inconstinence, increasing the bladder pressure. It is known that losing weight is an effective treatment for the disorder. Also, symptoms are observed to increase due to smoking. Also in younger women (20-49 years of age), quitting smoking visibly reduces the symptoms. Due to the stimulating / diuretic effects, caffeine and alcohol consumption is known to increase the severity of the disorder. Patients with the symptoms should plan to reduce the amount of caffeinated beverages consumed throughout the day”.

Environmental Factors Get Ahead of Genetical Risk

Reminding that genetically inherited tissue problems, collagen type and amount differences may be another important factor in urinary inconstinence, Dr. Melis Gökçe Koçer Yazıcı stated the following: “Conducted twin studies show that genetical factors do have an effect in urinary incontinence, yet environmental factors excess weight, smoking, physical exercise, diet and number of births might change this situation.” He stated that specifically overactive bladder condition might change with environmental factors, yet leaks following a sneeze or cough (stress-type) become less affected from environmental factors and more reliant on genetical factors. He stated “There are reports that there are 2-3 times more cases in women with stress urinary incontinence”.

It Can Also Be an Indicator of Different Diseases

Emphasizing that urinary incontinence might be the sign of other underlying disorders, Dr. Melis Gökçe Koçer Yazıcı stated: “Specifically diabetes, as it affects veins and nerves, neurological disorders, lung disorders with coughing symptoms, pelvic area masses, urinary infections or psychological disorders might occur before us with urinary incontinence. People who experience frequent urinary tract infections have an increased risk factor”.

Loss of Work Force, Depression, Sexual Anorexia

Stating that if untreated, the disorder reduces the quality of life socially and sexually, as well as may lead to a loss of work force, Dr. Melis Gökçe Koçer Yazıcı stated “Also, skin infections may be observed. Dehydration also might lead to other symptoms. Patients who have to wake up due to a full bladder at night may lead to anxiety disorders and depression in long-term”.

Explaining that all the systems of a urinary incontinence patient should be examined and underlying conditions have to be treated, Dr. Melis Gökçe Koçer Yazıcı gave the following information regarding the treatment:

“By examining whether it is a stress incontinence or an overactive bladder type of incontinence. First step in treatment is lifestyle changes, pelvic exercises and bladder training. If these do not prevent the symptoms, according to the type of incontinence, medical or surgical treatment might be necessary”.

A Lifestyle Change Is Required!

Stating that changing the lifestyle is a must, regardless of the treatment approach, Yeditepe University Hospitals Obstetrics and Gynecology Specialist Dr. Melis Gökçe Koçer Yazıcı finished his words as follows: “The best example is provided again with twin studies. Individuals with the same genetical structure may experience differences in overactive bladder incontinences, due to the environmental factors. Reducing beverages with gases and those with diuretic functions, avoiding constipation, limiting the liquid intake before sleep, weight loss (BMI <25), pelvic exercises, regular urination and quitting smoking might enable us to lessen or relieving the symptoms”.

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