Hello doctor,
I would like to know about urinary incontinence in women. Why is urinary incontinence more prevalent in women? Why do pregnancy and menopause contribute to incontinence?
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Female, unlike men, have short urethra and less effective urinary continence systems than men as a part of normal anatomy. Female normal continence is dependent on normal sphincter anatomy, normal vaginal anatomy, and pelvis muscle strength. Thus any factor causing changes in the above-mentioned area can lead to incontinence. After vaginal birth delivery, it is a normal process that the pelvic floor muscle becomes lax thus support system of bladder is reduced. This leads to hypermobile urethra and defected continence system. So problem like stress incontinence, urine leak during increase abdominal strainings like cough and sneezing, are increased and are typically common in elderly women with a history of vaginal delivery earlier. After menopause, the loss of estrogens in the body can cause vaginal atrophy which leads to less urethral support and is again one of the causes of incontinence in women. It is important to diagnose the cause of incontinence so that treatment can be individualized. Sling surgery, trans obturator tape, trans vaginal tape, are few surgical modality where support is given to bladder neck and urethra respectively thus improving the continence.
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