Doctor Lyubomir Malchev Puls – Blagoevgrad: Women are more prone to incontinence

Urinary incontinence is any unwanted or involuntary discharge of urine from the bladder that cannot be voluntarily controlled. It affects over 200 million women worldwide. The risk of developing incontinence increases with age, but it can also be observed in young women, says Dr. Lyubomir Malchev, head of the Obstetrics and Gynecology Department of MBAL “PULS” – Blagoevgrad, member of the European Associations of Aesthetic Gynecology and Gynecological Endoscopy , of the International Association of Ultrasound in Obstetrics and Gynecology.

A national campaign for stress incontinence is organized for the second year by Global Aesthetics after the successful first campaign last year. It will start on April 22 and end on May 22, and on May 10, free examinations will be carried out in more than 10 gynecological clinics in the major cities of Bulgaria participating in the campaign.

Incontinence is of several types. Stress incontinence occurs with exertion, straining, as well as sneezing, coughing, laughing or physical exercise, explains Dr. Malchev. Neurogenic incontinence results from damage or disease of the nervous system, such as stroke, Parkinson’s disease, or multiple sclerosis. An overactive bladder is manifested by the occurrence of a sudden and strong urge to urinate, which results in the leakage of urine within seconds. Overflow incontinence is leakage of urine due to an overfilled bladder. In functional incontinence, there is no pathology of the excretory system. In this case, conditions such as dementia, difficult mobility, impaired vision or severe forms of depression do not allow the patient to realize the urge and reach the toilet. There is also mixed incontinence, which includes a combination of several of the above types.

Women are more prone to incontinence. During pregnancy and childbirth, the muscles around the bladder area can be stretched or damaged, causing leakage. Changes in estrogen and progesterone levels, especially during menopause, can increase the risk of incontinence. The reasons can also be anatomical – in women, the urethra is shorter than in men. Certain gynecological surgeries, such as hysterectomy, also increase the risk of involuntary leakage of urine.

Lifestyle changes can help reduce or overcome incontinence. Dr. Malchev recommends losing weight first. Gaining weight can increase the stress on the muscles of the pelvic floor and the bladder area, it also leads to an increase in the pressure in the abdominal cavity. Limit alcohol and caffeine. These substances irritate the bladder wall and increase the frequency of urination. Do exercises for the pelvic muscles.
Pelvic floor training can reduce or prevent mild to moderate incontinence, she advises Dr. Malchev. Back in 1948, Dr. Kegel published his pelvic floor tightening exercises. These include a controlled contraction and relaxation of the muscles, similar to the sensation of voluntarily stopping the flow of urine midway through urination. Stronger muscles improve support for the pelvic organs, leading to better bladder and bowel control.

Do these exercises several times a week. There is enough information in the virtual space about Kegel exercises.

There are various modern medical solutions for the treatment of urinary incontinence. Medication includes medications such as anticholinergics or muscle relaxants to improve bladder control. Physiotherapists can suggest a program to strengthen the pelvic muscles and exercise the muscles that control urine. Operative treatment uses meshes or cloths as well as various surgical techniques. Injections of botulinum toxin into the muscles of the bladder can help reduce the involuntary muscle spasms that lead to incontinence. The most modern and gentle non-operative therapy is the laser.

“I already have more than 5 years of experience with the revolutionary Fotona laser system,” he says Dr. Malchev. – It offers non-surgical, non-invasive or minimally invasive treatment for vaginal relaxation, stress incontinence and vaginal atrophy. 3 procedures are applied at an interval of 1 month. Each treatment takes about 30 minutes depending on the procedure. It is painless, outpatient, and the patient can immediately resume their daily activities. Stress incontinence, relaxed vaginal walls and rejuvenation of the intimate area (in hypotrophy, after childbirth and menopause), vaginal atrophy and atrophic vaginitis, static disorders such as vaginal descensus (shrinking) are successfully treated.