Urogynecology is the field of expertise in which gynecology and urology-related diseases are examined together and diseases such as pelvic organ sagging and urinary incontinence are treated in women. The field of urogynecology deals with the treatment of problems such as urinary incontinence, bladder sagging, uterine sagging in women.
Urinary incontinence in women: It is defined as the involuntary outflow of urine in the bladder where urine accumulates, without the control of the patient. The urine accumulated in the bladder sends a signal to the brain to be expelled when the bladder is full. The disruption in this system causes the patient to incontinence involuntarily. When it becomes chronic, urinary incontinence is expressed as a disease.
Although urinary incontinence can be seen in all age groups, it is more common in older ages. Urinary incontinence in women occurs in different ways. There are different types of urinary incontinence such as stress-type urinary incontinence, incontinence in cases of compression, stress and compression together with urinary incontinence (mix), urinary incontinence in the form of bladder overflow.
Stress type urinary incontinence is the inability of the patient to hold his/her urine due to sudden reactions such as laughing,
sneezing, and coughing. Urinary incontinence can be defined as the sudden need to go to the toilet. It is a situation in which the patient suddenly feels the need to go to the toilet and, as a result, involuntary leakage of urine. In mixed urinary incontinence, both stressors and the sudden need for a toilet signal are seen together. In the overflow type urinary incontinence, it happens similarly to the urge type.
When the patient's bladder is full, it does not transmit a signal to the brain and urinary incontinence occurs as the bladder overflows.
In the treatment of urinary incontinence, it is first necessary to determine what type of urinary incontinence is by the doctor. Treatment methods are determined by the detection of urinary incontinence type by the doctor. After the physical examination, he/she obtains information about the bladder by applying tests such as blood sugar, urinalysis, urine culture and ultrasound. If deemed necessary, a complete diagnosis is made by urodynamic test or pelvic ultrasound.
After diagnosis, antibiotic treatment is started for urinary tract infections, depending on the severity of the disease. Various exercises (Kegel exercises) are recommended to strengthen the pelvic muscles. While surgical treatment is required in stress-type urinary incontinence; drug treatment is started in urge-type urinary incontinence.
Pelvic organ sagging: It can be defined as the displacement of one or more organs from the pelvic region to the vagina. Although it is not a life-threatening disease, it is uncomfortable and painful, but also reduces the quality of life. There are some factors that cause pelvic organ sagging. These are:
Weakening of vaginal tissues during pregnancy and childbirth
Weakening of muscles during aging and menopause
Depending on the severity of the sagging, the age and condition of the patient, pelvic organ exercises, hormone treatments, surgical procedure are applied. While changes such as changing lifestyle, regulating nutritional content, and losing weight are sufficient for some types of pelvic organ sagging, in more advanced cases, different techniques for surgical repair are clarified as a result of doctor-patient communication.