Urinary incontinence affects the person’s ability to control the passage of urine. The control of the bladder is lost and the bladder becomes weakened. It may range from occasional urine leakage to the complete inability of the bladder to hold urine. It is one of the most common and embarrassing problems. The risk for developing urinary incontinence increases with increasing age because the muscles of the urethra and bladder lose their strength due to ageing. It is more common in people over the age of 50. Women are more prone to urinary incontinence than men due to pregnancy, childbirth and menopause. Obesity, smoking, diabetes, neurological diseases and family history also contribute towards the development of urinary incontinence.
There are five types of urinary incontinence which are discussed below,
1. Stress incontinence
2. Urge incontinence
3. Overflow incontinence
4. Functional incontinence
5. Gross total incontinence
In stress incontinence, the control of the bladder is lost during some physical activity such as exercising, coughing, sneezing and laughing. These activities put extra pressure on the bladder. It is caused by the weakness of the sphincter muscles of the bladder.
In urge incontinence, the control of the bladder is lost after experiencing a strong, uncontrollable, involuntary urge to urinate. There are different causative agents such as urinary tract infections, bladder irritants, parkinson’s disease, bowel problems, Alzheimer's disease, multiple sclerosis, stroke, injury or nervous system damage.
In overflow incontinence, a small amount of urine may leak from your bladder. It occurs when you don’t empty your bladder completely. It is also known as dribbling. People with damaged bladder, blocked urethra, nerve damage and prostate gland problems are at higher risk for developing this type of incontinency.
In functional incontinence, the control of the bladder is lost due to physical or mental impairment. Due to these impairments, the person is unable to recognize the need for using the toilet, locate the toilet etc. It is also known as disability associated urinary incontinence.
In gross total incontinence, the urine may leak from your bladder continuously. There is no storage capacity of your bladder for holding urine. It is more common in people who are born with anatomical defect.
Urinary incontinence is caused by different factors such as underlying medical conditions, physical problems and some injuries. It can be caused when the muscles of the urethra and bladder lose their strength due to ageing. The overactive bladder muscles, blockage of bladder, enlarged prostate gland and cancer can also cause urinary incontinence. Urinary tract infection and constipation may cause urinary incontinence by irritating your bladder. Some neurological diseases such as parkinson’s disease, Alzheimer's disease, multiple sclerosis, stroke interfere with nerve signals associated with bladder control. As a result, they cause urinary incontinence. In men, enlarged prostate and prostate cancer also contributes towards the development of urinary incontinence. Certain foods such as alcohol, caffeine, chocolate, chili peppers and citrus fruits act as diuretics and increase the amount of urine by stimulating your bladder.
The symptoms of urinary incontinence may range from occasional urine leakage to the complete inability of the bladder to hold urine. The symptoms may vary from person to person depending upon the type and severity of disease. The most common signs and symptoms of urinary incontinence are discussed below,
The treatment of urinary incontinence depends upon the type, severity and other underlying medical condition of incontinence. The first approach used in the treatment of urinary incontinence is to control the bladder. Your doctor may recommend pelvic muscle exercises, biofeedback, and lifestyle modifications and timed voiding. The pelvic muscle exercises are performed to increase the strength of muscles used for urination. These exercises increase the holding capacity of your bladder. These are effective against stress incontinence. Pelvic muscle exercises are also known as Kegel exercises. In biofeedback, the sensors are used to control your bladder. These sensors will alert you about urination. Timed voiding based upon clock and it prevents the bladder from over filling. It indicates the time you should use washrooms. You should drink plenty of liquids or fluids in the form of water or juices or eat a diet rich in fibers if you are suffering from urinary incontinence. You must exercise regularly as it will strengthen your bladder muscles.The commonly prescribed medications for the treatment of urinary incontinence are anticholinergics. They will calm your overactive bladder. Antidepressants (imipramine, duloxetine), topical estrogen, alpha & beta adrenergic antagonist (phenylpropanolamine) can also be prescribed for the treatment of urinary incontinence. These medicines are used in combination with other techniques such as pelvic exercise or medical devices. The medical devices used for the treatment of urinary incontinence are urethral inserts, pessary, radiofrequency therapy, botox, bulking and sacral nerve stimulator. Your doctor can recommend you surgery if other treatments are not proved to be effective for you. The commonly used surgical procedures are sling procedures, colposuspension and artificial sphincter.
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