It consists of the involuntary loss of urine that causes a hygienic or social problem. It can significantly affect the quality of life of those who suffer from it.
Between 5 and 45% of women experience incontinence at some point in their lives. Between 1 and 39% of men may also be affected. Its frequency increases with age, and approximately half of those affected conceal it.
It can produce a significant psychological impact, sleep disorders, has a negative effect on self-esteem and autonomy, increasing the risk of social isolation, depression and sexual dysfunction.
There are many risk factors for developing incontinence, including pregnancy, vaginal delivery, complicated childbirth, obesity, menopause, age, dementia, neurological diseases, prostate enlargement, and pelvic surgery.
There are two fundamental mechanisms of incontinence:
- La stress incontinence (due to weakness of the urinary sphincter) which typically manifests as loss of urine with coughing and physical exertion.
- La urge incontinence (due to involuntary and inappropriate bladder contractions), characterized by a sudden and urgent need to urinate and the loss of urine at that moment or immediately afterward. These inappropriate contractions can be caused by neurological factors (multiple sclerosis, Parkinson's disease, diabetes, etc.) or non-neurological factors.
It is also possible for them to occur together (mixed incontinence) or through other mechanisms (overflow incontinence, or transient incontinence, for example when suffering from cystitis)
It is important to arrive at a correct diagnosis of the incontinence mechanism in order to address its treatment. This usually involves a physical examination and a series of complementary tests.
Treatment may involve lifestyle changes, rehabilitation through pelvic physiotherapy, drugs, neuromodulation techniques, or surgical interventions.
There have been significant advances recently in the surgical treatment of urinary incontinence. Previously, the procedures performed were aggressive (open surgery) with poor results. Today, we perform minimally invasive interventions with good results.
Today, all patients with incontinence can improve and most can be cured.
