Urinary Incontinence

What is urinary incontinence?

Urinary incontinence is medical condition where there is unintentional leakage of urine. Urinary incontinence is mainly of three types namely stress, urge and overflow incontinence depending upon the circumstances under which leakage of urine occurs. There are number of underlying medical conditions that may cause urinary incontinence such as diabetes, enlarged prostate, neurological disorders like spina bifida, multiple sclerosis, strokes and other conditions.

Women and the elderly are at a greater risk of suffering from urinary incontinence. The treatment depends upon the type, severity and underlying medical cause of urinary incontinence. Different options include behavioral training, physical therapy, different drugs and various surgical interventions.

Urinary Incontinence Symptoms

The symptoms depend upon the type of urinary incontinence.

  • Stress incontinence : Patients complain of dribbling whenever the pressure on the bladder increases especially during sneezing, coughing, laughing, exercise or lifting something heavy.
  • Urge incontinence : Sudden intense urge and followed by involuntary urination. The urge is so strong the patient may not have time to reach the toilet.
  • Overflow incontinence : Patient complains of frequent dribbling
  • Mixed incontinence : Patient may have symptoms of all types of incontinence.
  • Functional incontinence : Elderly people due to physical slowness may not reach the toilet timely although there is no problem with bladder function.
  • Total incontinence: Patients may suffer from constant dribbling of urine.

Chronic urinary incontinence may lead to number of symptoms like :

  • Skin problems – rash, ulcers, increased chance of skin infections due to chronic exposure to urine.
  • Repeated attacks of urinary tract infection characterized by fever, painful urination with burning sensation.
  • Anxiety.
  • Depression and social isolation.

Urinary Incontinence Causes

Urinary incontinence is caused by number of underlying medical or physical problems. There are some temporary and some permanent causes of incontinence.

Temporary causes include :

  • Alcoholism as alcohol acts as a bladder stimulant.
  • Drinking lots of water over a short period.
  • Drinking coffee as caffeine is a bladder stimulant and increases urine production (diuretic).
  • Carbonated drinks may act as bladder irritant and subsequently increases urine production.
  • Blood pressure lowering drugs, muscle relaxants, sedatives may hamper bladder control.
  • Urinary tract infection may lead to irritation of the bladder and constipation.

Chronic causes are :

  • Following vaginal delivery of baby and hysterectomy as the pelvic floor muscles responsible for bladder control may become weak.
  • Elderly people: in old age the muscles of the pelvic floor may become weak and the capacity of the bladder to hold urine is also compromised. In elderly women lack of estrogen leads to degeneration of the cells of the urethra which may lead to incontinence.
  • Prostate disorders like an enlarged prostate in elderly males, infection of the prostate (prostatitis) and cancer of the prostate and bladder cancer may lead to incontinence.
  • Neurological disorder like stroke, multiple sclerosis, Parkinson’s disease and trauma to the spinal cord may lead to damage to the nerves controlling bladder function.
  • Obstruction in the urinary tract due to urinary stones tumor.

Risk factors

Women and elderly people are at a greater risk of developing urinary incontinence. Obesity, long standing diabetes and smoking also increases the risk of developing urinary incontinence.

Urinary Incontinence Treatment

The treatment of urinary incontinence usually depends upon the underlying cause and severity of incontinence. Treatment options include :

  • Behavioral therapy like bladder training, regular visit to the toilet, avoiding alcohol and caffeinated drinks.
  • Physical therapy like pelvic floor strengthening exercise.
  • Drugs like anticholinergics and estrogen.
  • Surgery.

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