Leaking of urine also known as urinary incontinence (UI) is an involuntary and unwanted release of urine. Urinary incontinence presents a social and sanitary problem. Mechanisms that allow the collection of urine and the prevention of its uncontrolled leakage/ release are very complex. Depending on the cause of these mechanisms dysfunction, urinary incontinence is divided into several types: stress urinary incontinence which is most common, urge incontinence, and mixed stress and urge urinary incontinence.
Stress urinary incontinence
Stress urinary incontinence is a problem that affects more than one third of women in post-reproductive period /in menopause. Stress urinary incontinence is characterized by urine leakage caused by lifting heavy objects or straining, jumping, running, coughing, i.e. the activities that increase abdominal pressure.
The cause of stress urinary incontinence is the inadequate functioning of pelvic floor structures, in particular the increased laxity of connective tissue structures of the pelvic diaphragm, which provides urethra and bladder support. These structures include the entire length of the vagina.
Pregnancy, childbirth, lifting heavy objects, obesity and genetic predisposition are risk factors that can lead to stress urinary incontinence. Loose and stretched collagen connective tissues of the vagina provide poor bladder and urethra support, affecting the quality of sex life too.
It is estimated that 4% -14% of young women suffer from stress urinary incontinence, while in the population of women over 60, 12% -35% of women are affected by the condition. It is impossible to present more detailed figures, since only 15% of women aged 40 or more actively seek medical help for stress urinary incontinence. There is evidence that the connective tissue in women with stress urinary incontinence contains a reduced amount of collagen fibers. What is more, collagen connective tissues are structurally altered. Connective tissues intended to provide support for pelvic floor organs can no longer provide adequate support. Thus surgical and non-surgical methods are used to create bladder neck support in order to prevent involuntary leakage of urine. Surgical methods are relatively invasive and are not suitable for every woman. Today, the most common surgical method for treatment of stress urinary incontinence is the TVT (trans-vaginal tape) surgery. During the procedure, the bladder floor is supported by a tension-free tape.
It is the invasive character of surgical procedure which is the reason why many women do not seek help at the early signs of stress urinary incontinence. On the other hand, laser treatment is a minimally invasive method, requiring no anesthesia. Laser procedure entails no incision or bleeding. Recovery after surgery is rapid. Laser light heat effect causes the contraction of collagen fibers in the front wall of the vagina.
Urge urinary incontinence
Urge incontinence occurs due to various causes, and may be a consequence of a neurological disease. It is manifested by an urgent need to urinate, followed by the involuntary release of urine. Women are usually distressed by a high frequency of the urge to urinate, and by unpredictable patterns of stimuli that spur the desire to urinate (e.g. urine release before they reach the toilet). Urge urinary incontinence often results in a reduced capacity of the bladder and in an overactive bladder. It is more common in women of age. It is usually treated by medication. Successful non-drug treatment includes acupuncture and autogenous training ̶ psychotherapy, practiced in our clinic too. In urge urinary incontinence laser treatment proves inefficient.