Is there a cure for urinary incontinence? How to prevent urinary incontinence

Urinary incontinence is more common in women than men. Urinary incontinence is associated with many risk factors, including the number of pregnancies, body mass index, diabetes, depression, smoking, and age at the time of menopause… So, is there a cure for urinary incontinence?

There has been substantial research on urinary incontinence in Türkiye in recent years. The age range and demographics of men and women affected by this condition have begun to be revealed.
Prof. Dr. Oktay Demirkesen, Urology Specialist and Chairperson of the Turkish Continence Society, states that urinary incontinence has been on the rise in society over the years. Prof. Demirkesen shares important statistical information about this condition: “Urinary incontinence is a commonly seen condition in society. First of all, it should be noted that urinary incontinence is more common in women than men. Studies in the literature report that urinary incontinence occurs at least twice more commonly in females compared to males. However, a study conducted in Western Türkiye reported approximately four times higher likelihood of urinary incontinence in women compared to men. This is why women come to mind first when one hears the term urinary incontinence.


In studies investigating urinary incontinence in women across different regions of Turkey, urinary incontinence rates vary between 23 percent and 46 percent. A study presented at the 5th Congress on Functional Urology and Female Urology in early October 2017 reported the rates of urinary incontinence in women aged 25-65 years from 16 provinces of 12 different regions in Türkiye.
According to the results of this study, during which 1179 patients were interviewed, the rate of urinary incontinence was 42.7 percent. Reportedly, 40 percent of the study cohort described stress incontinence, that is, urinary incontinence that emerges with physical movement or activity, and 25.6 percent reported experiencing urine leakage before they could reach the toilet in time. In the same study, the rate of those reporting moderate to severe urinary incontinence that affected daily life significantly, was 8.5 percent. Despite potential variations depending on patient and geographical region selection, urinary incontinence rates are approximately in this range across different countries of the world.

In terms of the relationship between age and gender, urinary incontinence rates tend to increase with age in both genders. The increasing frequency of stress urinary incontinence in women in the age range of 40-60 years results in a peak frequency, which will steadily increase with the advancing age of the population.

Urinary incontinence in men has not been studied as thoroughly as in women. Urinary incontinence is very rare in adult men but increases steadily with advanced age. Over the age of 75 years, the rates become almost comparable between genders.



The relationship between urinary incontinence and socio-economic levels has been one of the research topics.

Socio-economic level is associated with numerous risk factors of urinary incontinence such as the number of pregnancies, body mass index, diabetes, depression, smoking, and age at the time of menopause.

The rate of naming urinary incontinence as a problem and seeking treatment is higher in individuals with higher socio-economic status. However, the relationship between the incidence of urinary incontinence and socio-economic level or the extent of discomfort experienced by patients has not been clearly established. On the other hand, when we were to consider educational status alone, a study we conducted showed that the rate of urinary incontinence decreased significantly with higher educational levels in patients presenting to urology and gynecology outpatient clinics due to complaints other than urinary incontinence, but the willingness to receive treatment did not vary by the educational level”, says Prof. Dr. Oktay Demirkesen.

Source: Haber Türk

Do not be ashamed! There are millions like you

Imagine that you have a health problem that you hesitate to talk about and try to live with, thinking that it is unresolvable. Moreover, you cannot avoid missing out on many special and beautiful moments in your life, solely because of this problem. Not to mention the fact that it even leads to depression as it takes you away from work and social life. Experts say that you do not have to endure all these unfavorable consequences and add: ‘Do not miss a thing in life, there is always a way as long as you wish’
Many women suffer from this condition but avoid naming it. Some people think that there is no solution, while the vast majority is simply embarrassed to see a doctor for this issue, eventually organizing their whole life around this problem. However, according to experts, most of these consequences stem from a lack of information.



So, what is this problem that women avoid talking about? URINARY INCONTINENCE… 400 million people around the world have this problem. In Türkiye, 2.7 million women, that is one in every four women over the age of 40 years, experience this condition. Studies show that 87% of women with this disorder in Türkiye lack self-confidence and 75% fear going out.

Chairperson of the Turkish Continence Society Prof. Dr. Oktay Demirkesen, who has conducted important research on female urology and functional urology, explains that this problem is more common in women. Citing data from the International Continence Society, Prof. Dr. Demirkesen states that 400 million people in the world and 50 million people in Europe suffer from urinary incontinence and that this issue is a growing problem in Türkiye as well.

Demirkesen explains the underlying causes of urinary incontinence, associated risk factors, and the ways to prevent this condition:

“Since urinary incontinence is often considered an embarrassing issue, I believe this project will be very beneficial. In studies on the incidence of urinary incontinence in Türkiye, we have observed that 25 percent to 40 percent of women suffer from urinary incontinence. Furthermore, a patient population of around 12-13 percent avoids seeing a doctor for urinary incontinence. In other words, a considerable number of urinary continence patients do not consult us, the specialists, for a solution. Embarrassment, family pressure, or pressure from the spouse may be the contributing factors in our society. Another factor is considering urinary incontinence incurable and this prevents individuals from consulting a specialist. However, with highly important advances in treatment methods, we achieve high success rates. Thus, we advise women to see a physician when they encounter such a problem.



Urinary incontinence can develop due to a variety of reasons. Although not commonly, it can occur as the primary symptom of certain neurological diseases. Therefore, urinary incontinence should not be ignored. This disorder may also cause psychological distress and depression. Withdrawal from work life, seeking early retirement, loss of labor force… Taken altogether, this is actually a condition that has many implications for healthcare systems.

Needless to say, not all urinary incontinence cases are the same. Therefore, appropriate treatment can be determined only after the cause is identified. We can roughly classify urinary incontinence into two groups as cases originating from the urinary bladder itself or its outlet. Underlying risk factors include aging, pregnancy, modes of giving birth, body weight, metabolic diseases such as diabetes, and mental problems of advanced age. The treatment process relies on an approach that takes all these aspects into consideration. Nevertheless, I can say that age is the most definitive risk factor. Genetic factors should be considered, too, when this problem occurs in several members of a family.



In order to prevent urinary incontinence, the pelvic floor needs to be strengthened. Exercise is an important factor for this purpose and workouts specifically scheduled for this condition contribute significantly. One should definitely engage in such workouts during the periods before and after giving birth. I recommend these exercises to all women, even in the absence of risk factors. For the purpose of avoiding any misinformation, I strongly recommend that physicians, who are interested in this subject matter, should instruct individuals about such workouts, which are referred to as Kegel exercises. Kegel exercises are highly beneficial, protective, and indeed have a therapeutic effect on urinary incontinence to a certain extent.”


Source: Sözcü Özel

Urinary incontinence affects work life unfavorably!

Yasemin Aydoğdu, Specialist in Psychology, says that urinary incontinence as experienced by approximately 2.7 million women in Türkiye leads to a lack of self-confidence, loss of self-esteem, feelings of shame and embarrassment both in men and women, thereby affecting lives negatively in all aspects.

In Türkiye, one out of every four women aged 40 years and over and one out of every 10 men aged 50 years and over suffer from urinary incontinence. Although urinary incontinence often occurs due to physiological causes, especially in women or men over 45 years of age, the disorder can take origins from psychological reasons. In this context, Yasemin Aydoğdu, Specialist in Psychology, states that the psychological effects of urinary incontinence are particularly challenging for women, who are in active working life, and explains the causes and solutions of this problem:

“Childhood traumas can manifest as urinary incontinence”

Noting that urinary incontinence can be due to psychological reasons, Aydoğdu says: “Urinary incontinence can occur in individuals of all ages including women, men, young people, old individuals, and children. Psychological urinary incontinence can occur in adulthood, especially as a result of certain situations experienced in childhood or later in life. Such situations may include being exposed to punishment during toilet training, having a family member suffering from urinary incontinence, witnessing an act of violence in childhood, hardly reaching the toilet in time, accidents, overreaction of parents to bedwetting, jealousy of a newborn sibling, academic failure, beatings, death in the family, divorce, migration, school-related trauma, hospital stay, inconvenient access to a toilet (toilet outside the house or inside the house), or emotional reactions to overly clean and tidy mother’s oppressive toilet training.”


“This problem challenges women both emotionally and in terms of work life”

Stating that urinary incontinence leads to a lack of self-confidence, loss of self-esteem, and feelings of shame and embarrassment both in men and women, affecting their lives in all aspects unfavorably, Aydoğdu emphasizes that urinary incontinence and related problems can be resolved as long as psychological support is received. Aydoğdu further adds that women in particular are emotionally damaged by this problem.

Psychologist Yasemin Aydoğdu notes that urinary incontinence poses an emotional challenge for women: “It triggers a feeling of shame and distress in most women. In some women, the problem can be severe enough to lead them to limit their daily lives. The condition can impair the quality of life of women through limitations to their personal freedom. Urinary incontinence when cleaning, walking, lifting an object, laughing, or sneezing may lead women to avoid people or going out in public. Since women with this problem urinate frequently and experience urinary leakage when they cannot reach the toilet in time, they spend efforts to find a toilet nearby when they are outside their homes. As expected, such situations upset women. Urinary incontinence negatively affects work life as well. A woman, who cannot refrain from thinking of the risk of leakage or need to run to the toilet frequently, cannot focus on her job tasks or may not sustain her attention during long meetings. They will need to go to the toilet frequently during the night too and may not get enough sleep and rest adequately”.

Aydoğdu states that individuals with urinary incontinence, who have normal findings in a urology examination, or those who continue to experience incontinence despite using the prescribed medications, can consult psychologists. “Situations experienced in childhood or later periods in life causing urinary incontinence today at the subconscious level are discovered, their meanings are discussed, and such issues are resolved with the hypnotherapy method. The negative aspects of experiences are clarified and reinterpreted along with the positive aspects of events; then, the thoughts that cause the problem can be modified to be followed by relevant suggestions to eliminate urinary incontinence”, says Aydoğdu.


Kaynak: İHA

Why do women experience urinary incontinence?

In Türkiye, one out of every four women aged 40 years and over faces urinary incontinence. So, how to acknowledge problematic urinary incontinence in women?

Stating that there is an increase in the number of women with urinary incontinence, the specialist explains that the incidences become comparable between genders in advanced age, that is, after the age of 75 years.

The expert summarizes the types of urinary incontinence in women as follows: “We can classify the types of urinary incontinence in women in three main groups.



‘Stress-type’ urinary incontinence, which refers to urinary incontinence resulting from exertional movement, is the most common type. Stress incontinence is a type of urinary incontinence caused by increased intra-bladder pressure. As the definition suggests, the word ‘stress’ in this term has nothing to do with psychological stress. Stress urinary incontinence may result from muscle dysfunction at the bladder outlet and the weakness of pelvic floor muscles supporting the bladder. Pregnancy and/or childbirth, previous surgeries, and obesity can be considered risk factors for stress urinary incontinence.

The second type of urinary incontinence, ‘urge incontinence’, manifests itself as difficulty reaching the toilet in time. The ‘mixed type’, where the first two types occur together, is another form of urinary incontinence. Additionally, other types of urinary incontinence have been described, but they occur rarely. For example, the patient may describe the problem as ‘I experience urine leakage continuously or without realizing’. Or, they may experience urinary incontinence during the night. However, these are mostly rare forms or may occur in the advanced stages of other types of urinary incontinence. Therefore, the types of urinary incontinence can be appropriately categorized into three groups as I mentioned”.



According to surveys conducted in Türkiye, it is estimated that 2.7 million women have urinary incontinence; however, only 31 thousand of these individuals consult a specialist physician for the solution of this problem.
The specialist points out that the awareness of urinary incontinence is low in our country, emphasizing that women with urinary incontinence in Türkiye mostly suffer from a lack of self-confidence and the fear of going out in public.



The specialist notes that urinary incontinence is a condition that affects the quality of life, having the potential to lead to psychological problems, including severe depression in women. The specialist adds:
“The frequency and severity of urinary incontinence takes a significant part in a person’s social life. In some cases, we observe that individuals fall short of their work expectations, failing to sustain their work efficiency or productivity. These result in losses in the workforce, having numerous relevant consequences. Moreover, this disorder can affect sexual life unfavorably with effects on the overall quality of life of the individual”.



Noting that several surgical and non-surgical treatment modalities are available for urinary incontinence, the specialist emphasizes that hygiene is particularly important even before treatment.
The specialist informs that treatment methods for urinary incontinence lead to successful outcomes, adding that the use of bladder pads can be highly useful until the patient benefits from treatment. The specialist says:
“The effect of urinary incontinence on the quality of life is usually associated with the severity of leakage. However, even a small amount of leakage has highly significant consequences for socially active individuals. We need to select the most effective treatment modality for these individuals as soon as possible. Moreover, it is also necessary to control urinary incontinence to avoid any further problems”.


Source: Star

Types of urinary incontinence

There are different types of urinary incontinence and each type may require a different approach.

If you experience urinary continence
When you cough,
When you laugh,
When you sneeze, then you may have “stress urinary incontinence”.
The word, “stress” here defines not your emotional state, but the physical exertion such as sneezing or coughing, which creates pressure on the abdomen.
• History of difficulty giving birth or problematic labor, giving birth to a large baby, and advanced maternal age may cause stress urinary incontinence even years after giving birth.
• In women, the aging process together with menopause can also cause this type of urinary incontinence.
• Stress urinary incontinence in men is usually seen after prostate surgery or pelvic fracture.
• In addition, serious respiratory diseases such as emphysema and cystic fibrosis, which cause frequent coughing, can also cause stress urinary incontinence.
Stress urinary incontinence develops due to weakening of bladder muscles.

Overactive bladder – Urge Urinary incontinence

Sometimes you may feel like you are stuck in the toilet even though your bladder is not full. If the urgency is followed by not being able to reach the toilet, then you may have ‘urge urinary incontinence’.
Although this urgency does not always result in urinary leakage, it can interrupt your work and social life due to the need to go to the toilet when you meet with your friends or during a business meeting:
• Urinary tract diseases caused by microbes such as cystitis in women and prostatitis in men,
• Having bladder stones,
• Benign prostate hyperplasia,
• Prostate cancer treatment,
• The presence of diseases that affect the muscle and nervous system such as Multiple Sclerosis and Parkinson’s can cause “squeezing type urinary incontinence”.
‘Urge urinary incontinence’ is caused by overactive work of the bladder muscles, in contrast to stress urinary incontinence, which is caused by weakened bladder muscles.
Note: Apart from all these reasons, for example, you may feel urinary urgency when you come home and try to open the door. Just like the involuntary mouth watering when one sees a lemon, the need to urinate, which you suppress until you get home is conditioned to arrive home and silently waits its turn. This type of urgency in front of the door to your home is not a physiological problem, it simply develops as a result of conditioning.

Mixed-type urinary incontinence

If you are experiencing signs of “stress urinary incontinence”, which develops due to the weakening of bladder muscles as well as signs of “urge urinary incontinence” caused by the overactive work of the bladder muscles, then you may have “mixed-type urinary incontinence”.
Although more common in women, men who have had prostate surgery and the frail elderly may also suffer from mixed-type urinary incontinence.

Overflow urinary incontinence

You may feel that your bladder is not fully emptied each time you urinate if your bladder opening, which should be relaxed for urine outflow, cannot relax enough after your bladder contracts. Some urine remaining in the bladder creates constant pressure on the bladder. This causes leakage of urine, leading to urinary incontinence.
This type of urinary incontinence is called “overflow urinary incontinence”.
• Narrowing of the bladder outlet due to prostate enlargement (in men),
• Uterus prolapse/sagging (in women),
• Diabetes-related damage to the nerves that control the bladder,
• Damage to nerve cells that regulate the bladder, such as spinal cord injuries
may all cause “overflow urinary incontinence”.

Functional urinary incontinence

Despite properly functioning bladder muscles and bladder, you may have difficulty in moving due to rheumatic diseases and you may therefore experience incontinence due to not being able to reach the toilet when you need. Such complaints are referred to as “functional urinary incontinence”.
• Rheumatic diseases that limit movement, which may prevent reaching the toilet,
• Nervous system health disorders such as dementia, Alzheimer’s, and stroke that prevent thinking about going to the toilet and taking action lead to “functional type incontinence”.

Reflex urinary incontinence

This type of incontinence refers to involuntary leakage of urine without any stimulation. In particular,
• Diseases that cause damage to the nervous system
• Accidents affecting the spinal cord structure
• Medical interventions that can cause nervous system side effects, such as radiotherapy, can cause this type of leak.

Temporary urinary incontinence

• If your urinary incontinence problem -which you experience due to urinary tract diseases caused by microbes such as bacteria, or medication such as diuretics that cause overwork of the bladder- resolves with the improvement of your current condition (e.g. if the problem causing urinary incontinence has responded to treatment or if you no longer need to use diuretics), then the problem you have is called “temporary urinary incontinence”.
• However, if your complaints of urinary continence persist, then you may have “permanent urinary incontinence”.

Fecal and urinary incontinence

Individuals with health problems that prevent them from thinking about going to the toilet and taking action, such as dementia, Alzheimer’s, stroke, and those who have been exposed to accidents that cause damage to nerve cells that regulate the bladder, such as spinal cord injuries may have fecal incontinence in addition to urinary incontinence.
Urinary incontinence can be taken under control and treated. Do not hesitate to ask for help from your doctor.


Reference: Accessed: April 2017.

Akın S. Yaşlılarda üriner inkontinans. Kontinans ve Nöroüroloji Bülteni 2015;2:49-54
Norton C. Conservative and Pharmacological Management of Faecal Incontinence in Adults. Ch 24. Committee 18. (Ch24, Committee 18. Accessed: April 2017.
Obokhare I. Fecal Impaction: A Cause for Concern? Clin Colon Rectal Surg 2012;25:53–58.