It is defined as the inability to avoid the emission of urine when you do not want to or cannot urinate. There are several types: stress, urge and mixed.
Therapeutic options depend on the type.
- Stress: slings or tension-free meshes / adjustable tension. Minimal invasive endoscopic surgery (Bulkamid®) or devices such as the artificial urinary sphincter for severe incontinence.
- Urge: injection of botulinum toxin, neuromodulation of sacral roots.
Treatment of urinary incontinence (UI)
Stress: when conservative treatment such as pelvic floor physiotherapy is not enough, we propose surgical treatment according to the severity of the incontinence and considering the clinical and personal history of each patient.
Surgical techniques range from the use of non-adjustable suburethral meshes, such as the TOT, or adjustable suburethral meshes such as Remeex® in case of moderate incontinence or failure of previous surgeries. More recently, the use of intraurethral agents such as Bulkamid® has been an innovation. It is a minimally invasive endoscopic procedure, without a surgical wound and with similar results to the use of suburethral meshes.
In the case of male UI, generally after prostate surgery, in addition to the use of suburethral meshes with adjustable tension such as Remeex®; Treatment may include anti-incontinence devices such as artificial urinary sphincter for the treatment of severe SUI with success rates of 90% or adjustable device such as ATOMS® for the treatment of moderate SUI.
Urge type: when medical treatment is not sufficient or is not effective, in the case of overactive bladder syndrome, treatment includes intradetrusor injection of botulinum toxin (Botox®) in both idiopathic (unknown cause) and neurogenic cases.
The treatment of urinary incontinence is a challenge for the urologist, as well as a disorder in the quality of life of the patient, that is why the treatment is not general but personalized and adjusted according to each patient.