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
– Pelvic floor exercises: (Kegel Exercises).
- Anticholinergic medication
- Alpha adrenergic blockers
- Bladder wall muscle relaxants
*Surgical Treatment: for SUI
- Burch Colpo-suspension: invasive method, rarely used.
- Sub-urethral Tape Slings: TVT & TOT
tape mesh sling inserted via the vagina to form a U shaped sling around the urethra, supporting urethra in coughing or sneezing, to stop urinary leakage.
- Electromagnetic Chair Waves
- Vaginal pessaries & inserts
- Platelet Rich Plasma: strengthens tissue
- Laser/ Radio Frequency:
Effective in mild cases, shrinks collagen fibers within vaginal mucosa, around urethra and bladder base to provide support.
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.
Amr Seifeldin, MD
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