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The Ilsan Paik Hospital Urinary Disorder Clinic is staffed by experts in urinary disorders, a urodynamic tester that tests bladder function on a computer, a video cystoscope that diagnoses the procedure while watching it with the patient on a TV screen, extracorporeal magnetic field therapy equipment, TVT, and endoscopic surgical instruments. It is a specialized clinic equipped with various surgical equipment, including the highly effective holmium laser.

The lower urinary tract is collectively called the lower urinary tract, which includes the urinating bladder, the prostate located below the bladder, and the urethral sphincter that acts to stop urination with force while urinating. The condition in which these do not harmonize with each other is called ‘micturition disorder.’ Urination disorders can be divided into urinary incontinence, which is a problem with storing urine, and obstruction of the lower urinary tract, which is a problem with urine discharge.

Urinary incontinence is a phenomenon in which urine flows out of the urethra regardless of one's will. Urinary incontinence may occur if bladder pressure abnormally increases and is higher than urethral resistance, or if the bladder is normal but urethral resistance decreases. Sometimes, the two factors occur in combination.

Urinary incontinence due to abnormalities in the bladder can occur when the autonomic nerves that control bladder function are damaged due to brain disease or spinal cord injury, acute/chronic inflammatory disease of the bladder, or bladder outlet obstruction due to prostate disease. Diseases that reduce urethral resistance are relatively rare, but they occur when the nerves that control the urethral sphincter or the sphincter itself are damaged and can appear after a traffic accident.

The frequency of urinary incontinence increases with age, occurring in 6 to 15% of the elderly, with 5 to 10% of cases being severe enough to require wearing pads. Patients with urinary incontinence are mentally hindered from visiting or contacting family or friends, or from social activities, which causes them to become isolated, which ultimately leads to child-like regression along with depression and lack of self-confidence.

Let’s look at common urinary incontinence in the elderly according to its cause and clinical manifestations.

Temporary urinary incontinence occurs when the amount of urine increases due to drugs such as sleeping pills and diuretics, diabetes, heart failure, etc., acute inflammation in the bladder, psychological factors such as hostility, depression, and anxiety, acute diseases such as high fever, and constipation. This is a case that occurs temporarily. There are many such cases, and urinary incontinence can be cured by treating the cause.

Urge urinary incontinence is a condition in which urine comes out in spurts without being able to hold it in when the urge to urinate occurs. This may be due to a lesion in the bladder. It can also occur as a secondary bladder change due to chronic cystitis, which is common in older women, or prostate disease in older men. Abnormal contraction of the bladder is diagnosed and treated through urodynamic testing, a bladder function test.

Overflow urinary incontinence occurs when there is a lot of residual urine in the bladder due to weakened bladder muscles, urinary tract obstruction, or both, reducing the functional bladder capacity (the amount that can be filled with urine). This is common in benign prostatic hyperplasia. It can be observed.

Stress urinary incontinence is common in women and occurs when the pelvic muscles are weakened after giving birth to many children or after surgery to remove the uterus, causing urine to leak out when laughing or going up and down stairs. The fundamental mechanism is that when abdominal pressure rises, the abdominal pressure is transmitted to the bladder, increasing intravesical pressure, but no force is given to the urethral sphincter that prevents urine from leaking, so urine flows out (Figure). In mild cases, it can be cured with oral medication or pelvic exercise therapy, but in severe cases, surgery is required. The recently developed tape technique (TVT, etc.) allows surgical treatment in just 20 minutes and has the highest healing rate (TVT in the picture).

Urinary tract obstruction

The urinary tract refers to the entire path from the kidneys where urine is produced, through the ureters, to the bladder, where urine collects, through the prostatic urethra, and the penile urethra, and then out of the body. A blockage in this passage causes urine produced in the kidneys to not flow down properly, causing the kidneys to drain. This is very important because increased pressure can destroy kidney function. In particular, urinary tract obstruction in the lower part of the bladder causes obstruction of both kidneys, which can lead to renal failure if it continues for a long time.

Obstruction of the lower urinary tract mainly manifests as difficulty in urinating. Difficulty urinating can be divided into functional obstruction in which urine cannot be discharged due to a problem with the nerves that control the bladder, which weakens the function of the bladder, and mechanical obstruction in which the urethra is narrowed, such as in prostate disease.

Diseases that cause functional obstruction can be divided into those caused by abnormalities in the nervous system and those caused by drugs. Neurogenic diseases include diseases affecting the central nervous system such as stroke, cancer, dementia, and Parkinson's disease; effects on the spinal cord such as spinal cord injury, tumors, and vascular disorders; and peripheral nerve effects observed in diabetes. Drugs include anticholinergics, antihistamines, and sympathomimetics, which are commonly used as bronchodilators.

Diseases that cause mechanical obstruction include severe phimosis, urethral stricture, urethral stones, urethral tumor, urethral diverticulum, and prostate disease, and among these, the most common cause is benign prostatic hyperplasia. Dysuria can be corrected by treating the disease causing the obstruction with medication or surgery.

Ilsan Paik Hospital Urinary Disorder Clinic

Testing equipment for urinary incontinence and urinary tract obstruction includes a urodynamic tester, which tests bladder function on a computer, and a video cystoscope (pictured), which diagnoses the procedure while watching it with the patient on a TV screen. Treatment includes pelvic muscle massage without taking off clothes. There are extracorporeal magnetic field therapy devices (pictured) that strengthen the body. In addition, the operating room is equipped with various surgical equipment, including TVT, endoscopic surgical instruments, and the most expensive and effective holmium laser.

Ilsan Paik Hospital Urinary Disorder Clinic

Testing equipment for urinary incontinence and urinary tract obstruction includes a urodynamic tester, which tests bladder function on a computer, and a video cystoscope (pictured), which diagnoses the procedure while watching it with the patient on a TV screen. Treatment includes pelvic muscle massage without taking off clothes. There are extracorporeal magnetic field therapy devices (pictured) that strengthen the body. In addition, the operating room is equipped with various surgical equipment, including TVT, endoscopic surgical instruments, and the most expensive and effective holmium laser.

*** Cystoscopy ***

*** Extracorporeal magnetic field therapy device ***

Is the cause of frequent urination simply inflammation such as urethritis, prostatitis, or cystitis, is it caused by bladder instability due to spinal damage, lesions in the bladder such as bladder cancer, or bladder stones, or is it due to obstruction of the lower urinary tract due to prostate disease, etc. Treatment will be completely different depending on whether the functional capacity of the bladder has been reduced due to urine remaining in the bladder.

In particular, urinary disorders that occur in older men over 65 years of age are often temporary due to constipation and drugs, and are mostly caused by benign prostatic hyperplasia. In older women, it is caused by stress urinary incontinence due to weak pelvic muscles and overactive bladder due to chronic cystitis. many. If you receive an accurate diagnosis from an expert and receive appropriate treatment, you can be free from pain or discomfort caused by urination and enjoy a satisfying life.

● Professors in charge: Urology Professor In-Rae Jo, Professor Jun-Seong Jeon, Professor Lee Kun-Cheol

● Inquiry number: 031)910-7230~1