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İstanbul / Güneşli
Kas Medical Center

Urinary Incontinence Treatment
With TOT Operation

    Urinary Incontinence in Women

    Urinary incontinence is one of the most common problems faced by women. Research shows that 20-46% of women of childbearing age and 40-69% of menopausal women struggle with urinary incontinence. This complaint, which occurs in the form of urine leakage from the bladder in cases such as coughing and straining, which may cause sudden increase in intra-abdominal pressure, can also be seen as inability to reach the toilet after urination. Women who suffer from urinary incontinence generally try to solve this problem by themselves, such as using pads and not leaving the house. However, urinary incontinence problem, which can cause psychological problems besides physical disorders, can be easily treated.  The bladder which urine is collected after draining from the kidneys and the urethra which carries urine out of the body are located in the pelvis.

    These organs are kept fixed by the muscles supporting the pelvic cavity from the lower part. Relaxation and weakening of these muscles can cause urinary retention and incontinence.

    The most important reasons for muscle relaxation and weakness are previous pregnancies and normal births, long-term constipation, overweight, diseases that cause chronic cough, menopause and old age. As a result of the relaxation of the pelvic muscles, bladder sagging (cystocele), rectum sagging (rectocele) and incontinence (urinary incontinence) can be seen.

    TOT (Transobturator Tape) method is successfully applied in our center as urinary incontinence treatment.

    TOT Method:

    The TOT method is a relatively new procedure. It was first described in 2001. In TOT technique, with a thin vaginal incision, a special band called ‘polypropylene mesh, is placed with the help of a special needle and the urethral canal is raised. Wound healing after surgery with this technique is quite rapid. Usually the patient is discharged after one day of observation. Complaints after operation are quite rare. The bladder is drained with the catheter placed in the bladder for the first 24 hours after surgery. The catheter is then withdrawn and the patient is discharged.

    At Kas Medical Center:

     – Diagnosis and treatment of urinary incontinence

    – Medical treatment (treatment with urinary incontinence drugs)

    – Urinary incontinence operations

    – TOT

    – TVT

    – Burch.

    – Non-surgical urinary incontinence treatment (biofeedback therapy) is applied.

    The following are common causes of incontinence:

    Obesity,

    Senile,

    Urine bag sagging,

    Genetic,

    Constipation,

    Cystitis,

    Vaginal infections,

    Stone in urinary tract or kidney,

    Diabetes,

    Menopause,

    Difficult births,

    Prostate enlargement in men,

    Muscle relaxants, blood pressure lowering, diuretic, sedatives, drugs taken against depression, allergy drugs,

    Dementia Alzheimer’s Disease

    Disease of the nervous system

    Fistula between vagina and bladder. (where the patient leaks urine from her vagina)

    Stress incontinence: Urinary incontinence in situations where pressure increases in the bladder, such as laughing, sneezing, coughing, lifting heavy objects. It depends on nerve and muscle weakness.

    Urinary incontinence: The patient suddenly becomes stuck in the urine and uncontrolled. There is uncontrolled contraction of the bladder.

    Mix type: Both situations are at the same time.

    Firstly, a detailed history is taken from the patient. The conditions that initiate urinary incontinence and the type and frequency of incontinence are learned. Blood sugar, urinalysis and urine culture, ultrasound and urodynamics may be requestedbfrom patient. If the underlying cause is considered, the related investigations are performed.

    Skin problems; Urinary incontinence causes continuous exposure of urine to the skin of the genital area and keeps the skin wet, and skin rashes, redness, ulcers (wounds) may occur in the genital area.

    Urinary tract infections; Incontinence can cause recurrent urinary tract infections.

    Changes in daily activities; As a result of incontinence, limitation of sports and exercise, the idea of ​​access to the toilet in places where daily plans can be made may limit the daily activities of the person.

    Changes in business life; Urinary incontinence negatively affects work life. It prevents participation in long meetings and can cause problems in concentration by causing stress and distress on the person. It can also cause fatigue and fatigue due to the division of sleep at night.

    Changes in quality of life; It may affect the quality of life negatively. A person’s self-confidence decreases, and sexual activity can be observed with fear of urinary incontinence and avoidance of sexual intercourse. In addition, diseases such as anxiety and depression are more common in women with incontinence.

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