What is Urinary Incontinence?
Urinary incontinence is a general term that describes situations where the bladder empties involuntarily. Normally, urine is stored and emptied under the control of the pelvic floor muscles and the urethral sphincter; however, when this order is disrupted, an incontinence table emerges, manifesting itself with sudden fluid leaks or complete emptying attacks. Urinary incontinence, which prevents social life, work and sports activities, also negatively affects physical comfort and self-confidence.
What Causes Urinary Incontinence?
When the bladder’s contraction threshold is lowered, urine leakage occurs due to both involuntary detrusor muscle activity and weakened pelvic floor muscles. Postpartum pelvic tissue tension, decreased estrogen levels with menopause, prolonged coughing, chronic constipation, or increased intra-abdominal pressure due to being overweight weaken sphincter function. Additionally, neurological disorders such as multiple sclerosis, Parkinson’s disease, diabetic neuropathy, and spinal cord injuries can affect the bladder nerves and cause incontinence.
What are the Types of Urinary Incontinence? (Stress, Urge, Mixed, etc.)
Stress type incontinence manifests itself as dripping during sudden increases in intra-abdominal pressure, such as coughing, laughing or lifting weights. Urge type incontinence involves an intense need to urinate and may be emptied before reaching the toilet; in this case, bladder hyperactivity and involuntary contractions predominate. Mixed type describes conditions where both stress and urge symptoms coexist. Rarer types such as neurogenic bladder, calculous disease or incomplete emptying are also included in the clinic.
Is Urinary Incontinence More Common in Women?
In women, the weakening of the connective tissue and muscles that provide pelvic floor support due to birth trauma, hormonal fluctuations, and decreased tissue elasticity during menopause causes a higher rate of incontinence compared to men. Increased intra-abdominal pressure during pregnancy and the baby passing through the birth canal can damage nerves and connective tissue. Estrogen deficiency after menopause also causes thinning of the urethra and vaginal tissue, negatively affecting continence.
When Should Urinary Incontinence Be Taken Seriously?
Leaks that occur more than once a day or with every physical effort seriously impair the quality of life. The risk of urinary tract infections, skin irritation, social isolation and emotional depression increases. If it is sudden onset, severe or accompanied by bloody urine, it may be a sign of a neurological disease. If there is a history of diabetes, neurological disease, stones or tumors, urinary incontinence should definitely be evaluated under the supervision of a specialist physician.
What are the Diagnostic Methods? (Physical Examination, Urodynamic Test)
Diagnosis is based on detailed history and daily urinary frequency chart. Physical examination includes manual assessment of pelvic floor muscle strength; stress incontinence is provoked by coughing or straining. Urodynamic testing is the gold standard method that graphs bladder pressure-volume curves, detrusor muscle activity, and urethral sphincter pressure. Additionally, post-micturition residual ultrasound measurement and pad testing quantitatively detect leakage. If necessary, advanced imaging and function tests such as cystoscopy or urethral profilometry are planned.
Urinary Incontinence Treatment Methods (Exercise, Laser, Medication, Surgery)
The first step in treating urinary incontinence is usually lifestyle changes and exercises to strengthen the pelvic floor muscles. In this approach, regularly performed Kegel exercises increase pelvic floor support and reduce stress-type incontinence complaints. Drug treatment aims to suppress involuntary contractions of the detrusor muscle with antimuscarinic or beta-3 agonist drugs in cases where the bladder muscles are overactive. Laser therapy stimulates the vaginal mucosa and adjacent connective tissue, increasing local collagen production, thus strengthening the support mechanism of the urethra and bladder neck. Surgical options include mid-urethral sling applications and pelvic floor revision surgeries; these provide mechanical correction of malpositioned or weak pelvic fibers. The method to be prioritized is determined individually, considering the type and severity of incontinence, the patient’s general health status and life expectancy.
How Effective Are Kegel Exercises for Urinary Incontinence?
Kegel exercises increase the ischemic and neurological resistance of the pelvic floor muscles, and provide significant benefits in a short time, especially in stress-type urinary incontinence. When an eight-week program of tightening and releasing exercises consisting of 10–15 repetitions per session, three sessions per day, is completed, most women experience more than half of their complaints. Pelvic floor reflexes become stronger in long-term applications, and bladder control against increases in intra-abdominal pressure during coughing, laughing or lifting is significantly improved. However, Kegel alone may not be sufficient for incontinence with high severity or neurogenic origins; however, it has a synergistic effect when combined with other treatments.
How is Urinary Incontinence Treated with Laser?
Vaginal laser treatment is usually performed using Er:YAG or CO₂ laser systems that apply superficial heat. The procedure is performed under local anesthesia or light sedation in office conditions. Laser energy provides controlled collagen remodeling in the vaginal epithelium and submucosal tissue; thus, the ligaments and connective tissues that form the pelvic floor support are tightened. A slight burning sensation and minimal discharge may be experienced in the early period, full recovery and maximum benefit occur after four to six weeks. A 60–80% improvement in stress and urge incontinence has been reported after one to three sessions. The fact that laser treatment is not as risky as invasive surgery and offers the opportunity to return to work quickly increases its preference among patients.
Urinary Incontinence Treatment Prices 2025
In 2025, Kegel exercise training and follow-up packages are offered in private clinics for ₺1,200–₺1,800. The cost of a drug treatment prescription and monthly medication is in the range of ₺400–₺700. Office-type laser is priced at ₺3,000–₺4,500 per session, and a three-session treatment package is usually priced at ₺8,000–₺12,000. Surgical mid-urethral sling operations cost between ₺25,000–₺35,000 with full packages covering surgery, anesthesia, hospitalization and follow-up. While the first two treatment options can be covered free of charge in limited indications in SGK-affiliated hospitals, an additional copayment may be required for laser and surgery.
Frequently Asked Questions
Is Urinary Incontinence a Natural Result of Aging?
Urinary incontinence is a condition that becomes more common as a result of functional weakening of the pelvic floor muscles, connective tissue and nerve endings with aging; however, this is not an inevitable fate for everyone. The decrease in estrogen levels with menopause causes the tissues supporting the pelvic organs to lose their elasticity and the capacity to hold urine decreases. On the other hand, the effects of age-related muscle weakening can be significantly reduced with regular pelvic floor exercises, healthy weight management and lifestyle adjustments. Therefore, while the risk of urinary incontinence increases in older age groups, quality of life can be increased with preventive measures rather than aging being the sole determinant.
Will Postpartum Incontinence Go Away?
During vaginal birth, the pelvic floor muscles and nerve structures may experience sudden stretching or tearing; for this reason, many women experience stress incontinence symptoms in the first months after birth. In most cases, muscle repair mechanisms and the recovery process in the connective tissue continue, especially in the first six months following birth. Regular and correctly performed Kegel exercises and physical therapy programs can significantly reduce incontinence by strengthening weak muscle fibers due to birth trauma. However, if there is a severe loss of pelvic support or nerve damage, physical recovery may be limited and additional treatment methods may need to be implemented.
How to Do Kegel Exercises?
In order to perform Kegel exercises correctly, the pelvic floor muscles must first be localized; for this, stopping the flow for a few seconds in the middle of urinating is a starting step in order to gain experience. Lying on your back is the most comfortable exercise position; the pelvic floor muscles (the muscle group that provides urine retention) are tightened and held for five seconds, then relaxed for five seconds and released. 10–15 repetitions should be done in each session and should be performed three times a day. Over time, the tightening time can be increased to ten seconds; as the endurance of the muscle fibers increases, the exercise can also be done in a standing or sitting position. Regular practice provides a significant increase in pelvic muscle strength within three months.
How Long Does Urinary Incontinence Treatment Take?
The duration of treatment varies according to the type and severity of the incontinence. In the conservative approach that starts with Kegel exercises, the first signs of improvement are usually seen within eight weeks; full functional level can be achieved up to three months. In urge type cases that require medication, symptoms are largely controlled within six months by adjusting the dose with regular monthly check-ups. In laser or office type minimally invasive methods, most patients can return to their daily functions after a single session, but the effect of full collagen remodeling and tissue compression reaches its maximum level in four to six weeks. In surgical interventions, the process from surgery to discharge usually takes three to five days, while potential recovery and effectiveness take one to two months.
Are Non-Surgical Methods Effective?
Nonsurgical approaches have high success rates in cases of mild to moderate incontinence. Biofeedback devices combined with pelvic floor physiotherapy increase the effectiveness of treatment by encouraging the patient to use their muscles correctly. Vaginal laser applications strengthen pelvic tissue by triggering collagen synthesis with low-energy rays that stimulate the vaginal mucosa; clinical studies have reported a 60–80% improvement in stress incontinence. Electrostimulation devices also strengthen neuromuscular communication and increase muscle tone. These methods are considered safe options that do not carry surgical risks and offer an uninterrupted return to social and professional life.