More common in women urinary incontinence the problem affects one's daily life negatively and reduces the quality of life. In the event of urinary incontinence, the feeling of discomfort caused by constant wetness, irritation, fear of smell can lead to the development of psychological problems up to depression. However, this problem can be solved with lifestyle changes and exercises as well as surgical methods.
Physical Therapy and Rehabilitation Department Uz. Dr. Gülseren Kayalar gave information about treatment with urinary incontinence and physical rehabilitation.
Difficult birth, smoking and obesity increase the risk
The problem of urinary incontinence, defined as "urinary incontinence", results in an overactive bladder-end stage. Occasional urinary incontinence in men usually occurs during a stressful physical effort such as coughing, sneezing, or a sudden, strong urge to go out.
In the development of this problem seen more in women, Risk factors such as age, number of fertility, forced labor, poor connective tissue, obesity, smoking, chronic cough, constipation, anal failure and bladder pains, past pelvic surgery or injury, urinary tract infections and menopause play an important role.
First step bladder rehabilitation in treatment
For a normal urination, anatomical structures consisting of bones, ligaments and muscles forming the pelvic floor and the peripheral nervous system should be healthy. Such weakening or breakdown of connective tissue in the hands leads to loss of function, overactive bladder and involuntary urinary incontinence.
The first step in treatment is bladder rehabilitation. This method; those with mild to moderate symptoms, those waiting for surgical treatment for stress urinary incontinence, those who did not accept surgical treatment, pregnancy planners and patients who are not eligible for surgical treatment.
Beware if you go out more than 7 times a day!
Bladder rehabilitation; ranging from lifestyle modification to voiding programs, bladder training to pelvic floor muscle exercises. Before the treatment is started, the patient is asked to keep a diary log for 24 hours. This data shows the amount of fluid ingestion by the patient over a period of one day. In the diary log, she records the amount of fluid she receives and removes for 24 hours. In addition, the type of fluid taken, the episodes of kidnapping, the frequency of urination and the activity of urinary incontinence should be recorded with their hours.
This diary from the patient is the cause of the urine volume, the incidence of urination, how often it is abducted, and the circumstances that increase or decrease it. For a healthy person, the daily frequency of urination should be between 4-6 in the day and 1-2 in the night. Therefore, it is not considered normal to go out more than 7 days in the daytime.
What to pay attention to within the bladder education program
1) Excessive fluid intake should be reduced and inadequate fluid intake should be increased.
2) At least 1,5-2 liters of fluid should be consumed per day.
3) Fluid intake should be avoided four hours before sleeping at night, and the bladder should be drained before bedtime.
4) Consumption of juicy fruits and vegetables should be avoided in the evening hours.
5) Excessive caffeinated, acidic, spicy foods and drinks and excessive alcohol consumption should be avoided.
6) Physical activity should be increased, balanced and regularly fed in a way to support weight loss.
7) If you have to give up smoking habit.
8) Dietary fiber foods should be added to prevent chronic constipation and difficulty in getting out of the toilet.
9) A routine toilet release program should be established and relaxing treatments should be applied in severe situations.
Increased bladder capacity is targeted
In bladder training, it is aimed to increase the bladder capacity of the patient by suppressing the urge to urinate and urinate at 3-4 hours intervals. When a person feels the need to urinate, they can urinate more than 2 hours after the last cataract. Otherwise a gradual program is being implemented. Other methods applied within the scope of independent bladder education; Kegel exercises, vaginal weight use, electrical stimulation of the pelvic floor, and biofeedback therapy.
Thanks to Kegel exercises; awareness of the coordination and function of the pelvic floor muscles, changing the periurethral levator ankle muscle fibers from fast-twitch fibers to slow-twitch fibers, increasing muscle strength and strength, and reducing symptoms. The use of vaginal weight in treatment is a means of strengthening and evaluating the pelvic floor muscles.
Exercises are made by moving five vaginal cones, each weighing 20-100 grams, one after the other in the vagina. Electrical stimulation of the pelvic floor is performed with vaginal or superficial electrodes to the pelvic floor muscle groups, vaginally or rectally stimulated with low dose electrical current. Biofeedback therapy is the reflection of the pelvic floor contraction and loosening to the patient through audiovisual signals via display and sound regulation.
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