Urinary incontinence is a common problem that occurs in both males and females. Incontinence occurs when there is an involuntary loss of urine or feces; the primary focus of this facility is urinary incontinence. Treatment for urinary incontinence depends on the specific cause and type of the incontinence, which must be determined by a specialist.
Types of Urinary Incontinence
There are five types of urinary incontinence.
- Stress Incontinence: Occurs when stress is placed on the bladder when pressure is exerted from sneezing, coughing, laughing or heavy lifting.
- Urge Incontinence: Occurs when an urge to urinate comes on suddenly and is followed by an involuntary leakage of urine. The urge to urinate can also be a solo symptom and happens frequently, even at night.
- Mixed Incontinence: Occurs when multiple or more than one type of incontinence are experienced.
- Overflow Incontinence: Occurs when the bladder constantly leaks due to the inability to completely empty the bladder.
- Functional Incontinence: Occurs when a mental or physical inability prevents you from making it to the restroom in time.
There are five different types of urinary incontinence, each with a different set of symptoms.
- Variable amount of urine escaping suddenly
- Urinary loss is predictable
- Leaks with increase in abdominal pressure (cough,laugh,sneeze)
Urge incontinence (also known as overactive bladder)
- Uncontrolled urine loss; strong urge to go to the bathroom
- Sudden and rapid urge to urinate without any warning
- Associated with frequent urination, urgent need to urinate, awakening at night to urinate
- Symptoms of both stress incontinence and urge incontinence
- Urine overflows from the bladder
- Small amounts of urine leak continuously
- Relatively normal bladder control
- Other conditions affect ability to reach the toilet on time
Your doctor will perform a detailed history and physical exam. Other testing includes:
- Avoiding Diary – your doctor may ask you to keep a record of your bladder activity
- Pad Test – test that determines whether the fluid lost is indeed urine
- Urine Studies (i.e. urinalysis, cytology, etc.)
- Post-void residual volume – test for the amount of fluid left in the bladder after urination
- Cough stress test
- Q-tip test
Treatment of incontinence depends on the type and severity of the problem. Simple lifestyle changes may help to improve some types of incontinence. These include limiting fluids at certain times or retraining the bladder by developing a schedule for trips to the bathroom. Kegel exercises are often recommended, to strengthen the pelvic muscles that help hold urine in the bladder.
Medication is sometimes prescribed to block the nerve signals that cause urgency and frequent urination, or to relax bladder muscles and prevent spasms. Your doctor will probably also review the medicines you already take, to find any that may contribute to bladder control problems and suggest changes that could solve the problem.
For patients who did not benefit from medication or lifestyle changes there is InterStim therapy, Botox injections, or percutaneous nerve stimulation. InterStim therapy modulates the sacral nerves with mild electrical pulses. This helps the brain and the nerves communicate so the bladder and related muscles can function properly. Percutaneous Nerve Stimulation also sends signals to the nerves of the bladder to decrease urinary incontinence. Finally, Botox injections help the bladder muscle to not contract as frequently.
Surgery can offer long-term relief for some types of incontinence. Many women have benefited from placement of synthetic material pads underneath the urethra to prevent incontinence.
The prognosis for urinary incontinence is excellent with currently available treatments. Patients with incontinence should not expect or experience morbidity and mortality. The well being of a patient with urinary incontinence varies depending on the escalation of the condition and symptoms, but urinary incontinence is easily preventable and treatable.
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