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Urinary incontinence at Menopause : Dr Sharda Jain

Urinary incontinence at Menopause : Dr Sharda Jain

1 of 33
Urinary
incontinence
at
Menopause
Dr Sharda Jain
2023 – 1 BILLION PM WOMEN
SPEND 40 % LIFE as postmenopausal
AGE at 46 YRS  Not changing
37 -40 % 0F TOTAL
50-64 YRE 23 %
65 + 16 %
Latest TRUTH
According to reliable sources there are more
than 20 crore women are suffering form any
form of INCONTINANCE & HALF are from
SUI
MARKEDLY UNDER-REPORTED / UNDERTREATED
The
TRUTH
USA :
The major ISSUE at
Menopause:
SUFFERING POPULATION
Especially women’s those who have given Vaginal birth
Or even during pregnancy
at or around menopause.
URINARY IN CONTINANCE 1 in 3 over 45 yrs
4 IN 5 AFTER MENO / SUI 1 IN 2
Urinary incontinence occurs when the pelvic floor
muscles that support the bladder and urethra are
weakened or damaged

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Urinary incontinence at Menopause : Dr Sharda Jain

  • 2. 2023 – 1 BILLION PM WOMEN SPEND 40 % LIFE as postmenopausal AGE at 46 YRS  Not changing 37 -40 % 0F TOTAL 50-64 YRE 23 % 65 + 16 %
  • 3. Latest TRUTH According to reliable sources there are more than 20 crore women are suffering form any form of INCONTINANCE & HALF are from SUI MARKEDLY UNDER-REPORTED / UNDERTREATED
  • 5. The major ISSUE at Menopause:
  • 6. SUFFERING POPULATION Especially women’s those who have given Vaginal birth Or even during pregnancy at or around menopause. URINARY IN CONTINANCE 1 in 3 over 45 yrs 4 IN 5 AFTER MENO / SUI 1 IN 2 Urinary incontinence occurs when the pelvic floor muscles that support the bladder and urethra are weakened or damaged
  • 12. The issue: vulvo vaginal atrophy symptoms 50% of the women suffer of GSM symptoms up to 4- 5 years after menopause, including dryness
  • 13. The ISSUE: INCONTINENCE • Incontinence in general population of females reported in 13 different large studies. •Young adult, 20% to 30%; • Middle age, 30% to 40%; • Elderly, 30% to 50%
  • 14. DIAGNOSIS Medical history • Physical examination-PAD test, paper towel test • Voiding diary • Urinalysis • Urodynamic test • Cough stress test • Sonography
  • 15. How do you interpret urodynamics results? Interpretation of Urodynamics consists of the 3 C's and 2 S’s. The 3 C refers to the sphincter's Capacity, Compliance, and Competence. The 2 S's refer to Sensation and Stability. Bladder capacity is studied to determine the amount of fluid the bladder holds.
  • 16. SUI Treatment Behavorial - Lose weight (Level 1) - Timed toileting/ intake (1a) -Treat constipation - Stop smoking (cough) - Avoiding high impact activities/heavy lifting - Kegels (Level 1) Non surgical - Pessary (Level II-III) Xx - Meds * Imipramine - Not very effective • Duloxetine • Mirabegron-25 MG • Sofifenacin-5 Mg Surgical
  • 18. TOT Transobturator Mid Urethral Sling J&J
  • 20. Advantages of laser treatments • 15-minute walk-in/walk-out procedure • Incisionless and virtually painless • No ablation, cutting, bleeding or stitches • No anaesthesia or antibiotics needed • High success rate and patient satisfaction
  • 21. WHAT are New Lasers? CO2 ,Yag, Infrared ,Diode Laser All laserare same in order to accelerate the production and the remodeling of mucosa’s collagen in the female genital organ, with an ongoing atrophic process (caused by age and/or muscular stress).
  • 23. Laser Treatment All laser treatment for female SUI are safe procedure with no side effects that can be done as a short office procedure. 90% of the patients have reported subjective improvement in SUI symtoms and there is 80% reduction of pad use altogether.
  • 24. Mechanism of action Tightening of collagen fibers and neo -collagenesis after Laser 1st phase : Photo thermal tightening of collagen fibers 2nd phase: Neocollagenesis
  • 25. Laser improves the vaginal muscular tone, strength and control of urine and it reduces its internal and external diameter. It restores not just health but confidence. We & our patients can go forward, live life to the fullest, embrace everything it has to offer.
  • 26. Laser Results Urinary incontinence After the treatment almost all patients (90-92%) affected by urinary incontinence( urge or sui ) obtained the complete remission of symptoms.
  • 28. German Laser Laser: wavelength 1470 nm (Diode ) •- Non ablative laser, most effective •- Highly penetrating compared to CO2 nd or ErYag
  • 29. WHERE ALL- IT CAN BE EMPLOYED? Applications -Stress Urinary Incontinence -Urinary Incontinence -Vaginal Atrophy -Vaginal Laxity -Vaginal Infection -Vaginal Itching -Vaginal Dryness / DYSPARUNIA -Vaginal Pain -Recurrent Vaginal Infection -Genitourinary Syndrome of Menopause -Vaginal rejuvenation & tightening postpartum - PostPartum SUI Optional-HPV, Cysts, Warts Treatment, Laser in hysteroscopy
  • 30. फायदा ही फायदा Advantages -Fully outpatient process -No Anesthesia -No side effects -Effective & painless -Non Invasive -No stiches -No blood loss -No burning -Day care procedure -Immediate Results -No downtime -ZERO Complications -Higher Self confidence
  • 32. 1. Fondly known as Teacher of Teachers 2. Director Lifecare Centre & Lifecare IVF 3. Founder & Secretary general of Delhi Gynaecologist forum , a body of over 2500 members . 4. Founder & Chairperson of North India Gynaecologist forum (NIGF) , body cover 8 stats + 2 union territory  Delhi & Chandigarh 5. NMC / MCI : Ethical committee member ,an apex body of 14 lacs modern Medicine doctors since 2018 till date 6. Business World : Included her in Top 20 Most Influential women in Healthcare in INDIA (8/03/22) 7. DMC Expert since 2009 to till date 8. Passionate medical activist..has given leadership role in removing Female Feticide , Movement of Anemia, Save Uterus Campaign, Save ovary Campaign and Every Mother Counts etc and now focusing on Zero mortality PPH, AMB , CCMB, Examination of Survivor Sexual assault / rape & POCSO cases. 9. Given concept of JANANI SURAKSHA YOJNA & ASHA WORKER to GOI. 10. Spearheading movement of Doctors safety /Medico legal Awareness /Unity of North India Gynaecologists 11. Decorated with many Lifetime achievement & Living Legend Award from many bodies including LHMC AA, FOGSI ,DMA ,DGF , WOW India, Delhi ISAR, Cloudnine , Bharat Vishva parishad Dr. Sharda Jain M.D. (PGIMER), MNAMS,FICOG,FIMSA,DHM, QM &AHO PGDMLS (SYMBIOSIS)