2023-12-12 20:30:00
Whether they occur following a laugh, a sneeze or even during a sporting activity, urinary leakage can spoil daily life and isolate the people concerned who end up reducing social activities for fear of accidents. This disorder – whose frequency and severity increase with age – mainly concerns women (1): 25 to 40% of them are affected according to studies. “This involuntary loss of urine through the urethra, occurring outside of urination, severely impacts quality of life, sleep but also sexual life. (read box)”, comments Dr Hervé Quintens, head of the urology department at the Princess Grace Hospital Center (CHPG) in Monaco. However, it remains a taboo subject. And, despite the significant increase in the number of women who consult, only 10 to 15% benefit from support.
For two years, the Monaco CHPG has been encouraging women to seek treatment by offering comprehensive care. via the “Pelvic center”. This care pathway functions as a one-stop shop for all women with pelvic conditions such as urinary incontinence. An update on this device with Dr Hervé Quintens.
Why does urinary incontinence require multidisciplinary care?
This is a complex pathology and the risk factors are numerous: obesity, sedentary lifestyle, multiple childbirths, repeated efforts, menopause, chronic constipation or prolapse (descent of the pelvic organs)… Also, the management of this disorder must involve numerous specialties, with the objective of offering the right treatment, the appropriate technique, to provide the right indications according to the symptoms, expectations, and profile of each woman… This is what we offer within the ” pelvic center”.
How is this care pathway organized?
Over the course of a day, the patient benefits from the advice of several specialists: urologist, gynecologist, gastroenterologist, radiologist, physiotherapist, sexologist, etc. These professionals then meet to decide together on the most suitable treatment for urinary incontinence and to associated disorders. This can involve perineal rehabilitation but also sessions with the sexologist in the event of difficult and/or painful sexual intercourse, follow-up from the gastroenterologist in the event of constipation or even care from a nutritionist in the event of weight problem.
This multidisciplinary approach is very effective: many women see an improvement in their quality of life by changing certain daily habits.
When should you consult?
Urinary incontinence is a benign disorder. This is why we only treat patients who are really bothered on a daily basis, knowing that it is not the quantity of urine lost which determines the need for treatment. For example, an elderly person can have profuse leaks without it impacting their life. Conversely, a 40-year-old woman, very active and sporty, may feel ashamed or embarrassed if she loses a few drops following jogging or in the middle of a work meeting. The feelings of each woman are decisive in the care.
1. Unlike women, urinary incontinence in men is most often iatrogenic, that is to say it is a consequence of medical or surgical treatment.
Urinary incontinence affects between 25 to 40% of women according to studies, and impacts quality of life, sleep but also sex life. (Photo Pexels)
Three forms of incontinence
1. Stress urinary incontinence (or sphincter) is due to weakness of the pelvic muscles. Loss of urine occurs during exercise (walking, changing position, jumping, but also during minimal effort: coughing, laughing, sneezing, etc.). It represents 40% of cases.
2. Overactive bladder incontinence (or by urgency) leads to pressing desires, difficult to control. The need is felt suddenly and it is difficult to hold back. It can occur at any time, even at rest and at night. It concerns 10% of cases.
3. Mixed urinary incontinence combines the two types of symptoms and represents 50% of cases of urinary incontinence.
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