Urinary incontinence at Menopause : Dr Sharda Jain

1. 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

4. The
TRUTH
USA :

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

7. Stress

9. SILENT SUFFERING++

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

17. Burch Colposuspension for SUI

18. TOT Transobturator Mid Urethral Sling
J&J

19. LASER THERAPY

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).

22. Revitalize and Rejuvenate

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)

33. Thank you