Urinary incontinence affects 70% of women between 50 -70 years, many women suffer in silence thinking it is a normal aging process, with no treatment for urine leakage. It posses a tremendous physical & psychological limitation to their professional and social life styles, and embarrassment in front to family and friends.
. Stress urinary Incontinence: (SUI) Escape of urine during a cough, sneeze or laugh
. Over Active Bladder: (OAB) Frequent Urination or a compelling desire to pass urine
. Nocturnal Enuresis: (NE) Unconscious bed wetting at night
. Overflow Incontinence: Overflow of urine after bladder is filled due to neurological causes
. Urinary Fistula: An abnormal passage between the bladder and vagina
. Loss of urine during intercourse
. Loss of urine during sports
Child birth trauma, aging, constipation, chronic cough, and obesity are factors leading to weakness of pelvic floor muscles, and laxity of ligaments, causing lack of support to pelvic organs and urine leakage.
. Involuntary loss of urine with a cough, sneeze, laugh, or straining.
. Frequent urination & poor bladder control
. Compelling urge to urinate
. Loss of urine before reaching toilet
For Over Active Bladder (urogynecology)
– Bladder retraining: urinating with a schedule, improves patient control.
– Avoiding dietary irritants to bladder such as: . SPICY FOODS – VINEGAR – CITRUS FRUITS – COFFEE – TEA – CHOCOLATE – ASPARTUM – SODAS.
– Pelvic floor exercises: (Kegel Exercises).
– Physiotherapy: for pelvic floor muscles.
*Medical Treatment: Highly effective in OAB:
- Anticholinergic medication
- Alpha adrenergic blockers
- Bladder wall muscle relaxants
*Surgical Treatment: for SUI
– Burch Colpo-suspension: invasive method, rarely used.
– Peri-urethral Injection: of collagen material forming a sphincter.
- Sub-urethral Tape Slings
- Artificial sphincter: inserted in urethra, to open a valve for urinating.
- Vaginal pessaries & Urethral inserts: temporary control urine leakage.
- Laser/ Radio Frequency Vaginal Correction: Effective in mild cases, fractional laser beam or RF, shrink collagen fibers within vaginal mucosa, around urethra and bladder base to provide support to correct urine leakage temporarily.
Mid-Urethral Slings (TVT – TOT – Mini Arc):
Minimal invasive procedure: a tape mesh sling is inserted via the vagina to form a U shaped sling around the urethra, providing supporting in increased intra abdominal pressure like coughing or sneezing, to stop urinary incontinence & leakage.
Three generations of Mid-Urethral Tape Slings: (TVT – TOT – Mini Sling), it takes 20 minutes to apply, new generations carry less side effects, and complications. Patients can resume normal duties the following day after surgery with a success rate of 90%.
1st Gen. – Retropubic sling: (TVT sling)
2nd Gen. – Trans-Obturator sling: (TOT sling)
3rd Gen. – Single incision Sling: (Mini Arc Sling or TVT secure)
Platelet Rich Plasma(PRP) :
PRP is used in urogynecology by injection in the peri-urethral area, anterior vaginal wall and clitoris, This has helped may women especially mid-aged to increase intimate sensitivity and control their urinary incontinence.
It is a simple shot of patient's own blood plasma, prepared by a special technique to concentrate natural growth factors which stimulate stem cells in the region and revitalizes the vaginal mucosa epithelium.
Other non invasive methods of treatment are:
- Hormone Replacement Therapy
- Amniotic Fluid Growth Factors
- Stem Cell Therapy
- Laser/RF Vaginal Rejuvenation
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