Treatment of Urinary Incontinence and Pelvic Organ Prolapse

About the disease

Urinary incontinence is a painless disease of the urinary tract, which results in a person completely losing the ability to control the bladder. There are many reasons why someone may develop urinary incontinence, for example infections, consumption of muscle relaxants, psychological problems, obesity, but the most common cause is pelvic organ prolapse. This condition can develop after a strenuous childbirth that lasted several hours, or after a long-term cough. Pelvic organ prolapse causes an organ of the urinary tract, such as the bladder, urethra or vagina to slip from its normal position and push against other organs. 

Overall, urinary incontinence is a very common condition. According to American website MedScape, 50-84% of the elderly have urinary incontinence. It is twice as common in women as it is in men. Also, people who frequently find themselves in stressful situation are 37% more likely to develop urinary incontinence in future. 

Symptoms

Urinary incontinence symptoms include:            

• Involuntary urination
• Inability to hold urine for a long time
• Urine leaks out when the sufferer is laughing and/or feels excited, nervous or frightened

Pelvic organ prolapse symptoms include:          

• Pain during sexual intercourse
• Feeling of fullness in the abdomen
• Pressure in the pelvic organs
• The sufferer may feel their other organs pushing against the urinary tract
• Constipation

Diagnosis

• Urinalysis is the most common diagnostic measure for this type of disease. It allows the doctor to determine whether there are any abnormalities in the urine sample, which can indicate the presence of infection.
• Urodynamic testing is used to measure how much pressure the patient’s bladder can hold.
• Ultrasound can determine whether urinary incontinence is being caused by a prolapse and if so, which organ has prolapsed. 

Treatment

Surgery includes such options as a sling implantation, the installation of a polypropylene mesh monarch and prolapse surgery.

• Sling implantation: a pelvic sling is attached around the urethra, preventing involuntary urination while laughing or coughing.
• The installation of a polypropylene mesh monarch also aims to create support for the urethra. This treatment method is less invasive than sling implantation and it has fewer complications.
• Prolapse surgery reattaches the prolapsed organ to its initial position, so that it will not create extra pressure on the bladder.

Overall, urinary incontinence treatment is very successful, with almost 90% of patients reporting good results.

Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed