Urinary incontinence is more common in women

Urinary incontinence, which is highly prevalent in the Brazilian population, can occur in women, men and children. Urinary incontinence is the involuntary loss of urine through the urethra. According to the Brazilian Society of Urology (SBU), the problem affects 45% of women and 15% of men over 40 years of age.

The coordinator of the Department of Voiding Dysfunction at SBU, Alexandre Fornari, told Agência Brasil this Friday (2) that, in urinary incontinence in general, the most common cause is bladder malfunction, called overactive bladder.

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“It's when the person is standing still and, out of nowhere, they have an urgent urge to urinate. And you have to urinate, otherwise you leak urine. Sometimes there isn't enough time and it ends up leaking. It can occur in men and women and most of the time it does not amount to incontinence; It’s just urinary urgency.”

In children, the most common incontinence results from neurological problems or problems related to learning to urinate, when removing diapers. In men, Fornari stated that “the older you are, the more incontinence you have”.

The disorder can generally be related to neurological problems or prostate problems, the most common cause. “It affects both those who have prostate surgery and those who don’t. And, sometimes, it needs to be done, precisely to treat this urinary incontinence, because the fact that the prostate blocks the exit of urine a little makes the bladder function poorly and leads to urinary incontinence”, said the urologist.

In women

In women, which is more common, there is stress urinary incontinence. “When she coughs, sneezes, lifts weight, she loses urine.” The doctor explained that although it is normally thought that the biggest risk factor is pregnancy and childbirth, this is actually the second biggest risk factor.

The first is family history. “Mothers, aunts and older sisters who experience urinary loss on exertion end up being the biggest risk factor.” This is generally related to a problem that is the sphincter, a muscle that is at the exit of urine and that has to hold urine but, for some reason, is not holding it well.

“This could be a result of aging, of effort.” The most significant thing is the quality of collagen, which is present in the ligaments that support this region and which has a genetic part as a risk factor”, said Alexandre Fornari.

He stated that, in women, the most common thing is to have urinary incontinence from the age of 45 or 50. In men, the older they are and the more prostate problems they have, the higher the incidence.

Treatment

The first step towards treatment, “and most important of all”, according to the specialist, is to see what type of urinary incontinence is. Considering the most common, which would be overactive bladder, treatment can be with physiotherapy and medication, “which solve 85% of cases”. In cases where these two treatments do not work, Botox can be applied to the bladder or a pacemaker can be implanted in that organ.

When it is a prostate problem, medication or surgery is recommended. In the case of stress urinary incontinence, which occurs more in women, the treatment is physiotherapy or surgery, when a mesh is placed under the urethra to provide support and improve the functioning of the sphincter muscle, which was not holding urine.

The coordinator of the SBU Department of Voiding Dysfunction advised that both women and men, who are affected by urinary incontinence disorder, should seek out a urologist, who is a doctor specializing in the urinary tract.

“They are trained to treat all types of incontinence, whether due to neurological or stress causes. The most appropriate professional would actually be the urologist, who will recommend the correct treatment for that patient.”

Cure

Fornari assured that incontinence in women can be cured. “It’s possible to stay dry. Sometimes the path is a little longer. Sometimes you need surgery, sometimes a few physiotherapy sessions will do the trick. Other times, she has to get a pacemaker for her bladder.”

In the doctor's opinion, it is very difficult to have a situation that the specialist cannot resolve. In this case, he highlighted that there are several ways to alleviate the impact of incontinence, including products such as diapers, pads and implantable devices. “There are many things you can do to improve the situation when there is no cure. But it is difficult not to be able to resolve urinary incontinence”, he highlighted.