Why does urinary incontinence occur?
Urinary incontinence is a disease of high prevalence, which can affect even more than 20% of women in our country. In men, it is somewhat lower but there is also a prevalence of over 5% or 6% depending on the pathology present in the male. Generally the most frequent urinary incontinence in our country, which is female, is caused by a mechanical problem, the pelvic floor over the years and with childbirth weakens, loses all its strength and consistency and this makes the urethra does not have adequate support when urinating. Therefore, when abdominal pressure increases, patients lose urine through the urethra because it has nowhere to support it. It is basically a mechanical problem.
What types of incontinence are there?
We could say that there are basically two types of incontinence: stress incontinence which is the situation in which the patient, when coughing, laughing or somehow increases abdominal pressure, suffers a loss or leakage of urine. The second most frequent type of incontinence would be urge incontinence which is the situation in which the patient has the urge to urinate and is absolutely unable to control the urge to urinate and has to quickly look for a bathroom to urinate because if not found, the patient urinates, the urine leaks. Apart from these two, which are the most common, there are some others related to some type of drug or to slightly more complex diseases. But to focus on the two most prevalent, let’s say there are two, stress incontinence and urgency incontinence, urgency incontinence. These are the two most common.
What is the appropriate treatment?
The treatment of the two incontinences we are talking about has fortunately become much simpler nowadays. The initial treatment for urge incontinence is a pharmacological treatment and if the patient does not respond to these pharmacological treatments there are various options such as neurostimulation of the posterior tibial nerve, or even the injection of a substance such as Botox, intravesical, which achieve a very high percentage to reduce the problems of urinary urgency. In the case of stress incontinence, which also has a very high prevalence as we have mentioned, the treatment is radically different. Since it is a mechanical problem, as we have said previously, the fundamental treatment is going to be a surgical treatment, based on providing the pelvic floor with adequate support so that the urethra, when the abdominal pressure increases, has a place to rest and therefore the urine does not escape. Fortunately, nowadays this surgery is very advanced, they are surgical techniques that require no more than 30 or 40 minutes and the results are, frankly, very good.