MEDIKABAZAAR IS IN CONVERSATION WITH ONE OF THE RENOWNED UROLOGISTS

Medikabazaar is in conversation with one of the renowned Urologists, Dr Sanjay Pandey. He is an expert in reconstructive urology, andrology, endourology, female urology, incontinence, and gender reassignment surgery and is associated with Kokilaben Dirubhai Ambani. He has operated more than 250 complex reconstructive urology procedures and so, we chat with sir to get more insights on Urinary Incontinence in female and the issues faced.

What is Urinary Incontinence? Urinary Incontinence is a complaint of involuntary leakage of urine. The term urinary incontinence refers to any type of involuntary urinary loss. Of the 25 million adult suffering from some form of urinary incontinence,75-80% of those are women. Urinary Incontinence affects 200 million people worldwide. One in three women over the age of 18 experience episodes of leaking urine involuntarily. Concerns with the increase in urine leakage due to pregnancy, childbirth, and menopause that are causing problems to the pelvic muscles have increased. This has led to increase use of diapers and reduced quality of life.many people experience occasional, minor leaks of urine. Others may lose small to moderate amounts of urine more frequently. Urinary incontinence has types such as Stress, Urge, Mixed.

What is Stress Incontinence?

Stress incontinence is a complaint of involuntary leakage on effort or exertion, or on sneezing or coughing, laughing and bending and a major reason for incontinence issues which needs to be addressed.

How common is stress incontinence in India?

Population studies show a prevalence of urinary continence in 10%-42% of Indian women. It shows a clear trend towards increase in prevalence. About 1 to 3 women suffer from SUI at some point in their lives.

What causes stress incontinence?

Urethral support, bladder neck function, and function of the urethral muscles are important determinants of continence. Damage to the connection between this fascia and muscle, loss of nerve supply to the muscle, or direct muscle damage can influence incontinence.

What are other reasons of Incontinence for the urge and mixed urinary incontinence?

Urge incontinence & mixed continence. Urge incontinence is complaint of involuntary leakage accompanied by or immediately preceded by urgency and mixed incontinence is complaint of involuntary leakage associated with urgency and also with exertion, effort, sneezing, or coughing leading to overactive bladder or nocturnal enuresis.

What is Nocturnal enuresis?

Nocturnal enuresis is complaint of involuntary loss of urine that occurs during sleep.

What is overactive bladder?

Overactive bladder (OAB) syndrome as “urinary urgency”, usually accompanied by frequency and snocturia, with or without urgency urinary incontinence (UUI), in the absence of urinary tract infection (UTI) or other obvious pathology.

Can we prevent Stress Incontinence?

Prevention is better than cure. Prevention of Stress incontinence includes life style modifications, high fiber diet, quit smoking, losing excess weight, and avoiding over indulgence in caffeinated, carbonated and alcoholic beverages and Kegel exercises to strengthen your pelvic floor muscles and urinary sphincter.

What are the symptoms of stress incontinence?

The main symptom of stress incontinence is a leakage of urine at times of physical movement or activity. Examples of the kinds of activities associated with urine leaking include laughing, coughing, lifting heavy weights or exercise.

When do you suggest that one needs to visit the Urologist?

If you’re embarrassed by urine leakage, forced to wear diapers due to this involuntary leak and you avoid important activities because of it visit you must visit your Urologist.

How does a Urologist can help in curing in Incontinence?

Urinary complaints are best addressed to a Urologist or Gynecologist with your history and needs. The severity is addressed and evaluated by set or needed investigations namely voiding diary, Uroflowmetry and Urodynarnics if needed to take bothersomeness of Incontinence towards treatment and cure depending on the state and evidence.

Is stress Incontinence age and gender specific?

Women experience stress incontinence twice as common as men; Pelvis & urinary sphincter muscles weaken by child birth & menopause resulting in more episodes of leakage of urine and incontinence.

How is Stress Incontinence diagnosed?

The diagnosis need detailed medical history, physical examination, Stress test (in which the doctor observes urine loss when you cough or bend down), pelvic and rectal examination and neurological examination, urine analysis and blood tests. Evaluation tests are needed as Sonography, cystoscopy, urodynamic study may be indicated in right cases

Is Stress Incontinence curable?

Treatments are available to cure or significantly reduce the effects of stress incontinence from your life.

What are complications of Stress Incontinence if left untreated?

Urinary tract infections: Incontinence increases your risk of repeated urinary tract infections.

Emotional distress: If you experience stress incontinence with your daily activities, you may feel embarrassed & distressed by the condition. It can disrupt your work, social activities, relationships and even your sex life.

Can Stress Incontinence be cured by medications and meditation?

Medications act as an adjunct to other therapies of stress Incontinence like behavioural therapies, pelvic floor exercises and surgery.

Do pelvic floor exercises help in curing Stress incontinence?

Pelvic floor muscle exercises are considered first line treatment for stress incontinence. They are most helpful in post-delivery period to rejuvenate stretched pelvic floor.

When should a patient of Stress Incontinence be offered surgery?

Surgery is usually done only after conservative Kegel fails and patient finds significant leak to minimal stress or need for diapers as neglected state.

What Surgery is done for Stress Incontinence?

Surgery can fix stress urinary Incontinence. Various surgical options in Stress incontinence include Colposuspension, Sling surgery, vaginal mesh surgery (tape surgery). Urethral bulking agents and artificial urinary sphincter.

Which is the best suggested surgery suggested by you?

Sling surgery, this is the most common surgery we doctors use to treat urinary stress incontinence. That's when certain movements or actions, like coughing, sneezing, or lifting, put pressure on your bladder and make you pee a little. The surgeon creates a “sling” in this surgery, a small strip of material is placed under your mid urethra to prevent it from moving downward during activities. It acts as a hammock to There are many slings available out of support the urethra. which personal experience sling that works well is I STOP brand from Medikabazaar.

What is the message to the society and all women in Incontinence?

Incontinence can’t be avoided but delays can be avoided. Living with urgency, incontinence and diapers can be prevented by understanding oneself and the awareness attempt. Women suffer in silence. Only you can make the difference and bring your urinary health to the front row seat.