What Is Urinary Incontinence?
Urinary incontinence, or the inability to control the release of urine from the bladder, affects nearly one in 10 people over age 65. Incontinence occurs when the muscles in the bladder that control the flow of urine contract or relax involuntarily. This results in either leaking or uncontrolled urination.
Urinary incontinence can range from mild occasional leaking to chronic uncontrolled urination. Incontinence itself is not a disease, but a symptom of an underlying medical condition. Incontinence may be a temporary problem caused by a urinary tract or vaginal infection, constipation and certain medications, or it can be a chronic condition. The most common causes of chronic incontinence include:
Are There Different Types of Urinary Incontinence?
While there are many different types of urinary incontinence, the most common include stress incontinence and overactive bladder, also called urge incontinence.
Stress incontinence occurs when there is unexpected leakage of urine caused by pressure or sudden muscle contractions on the bladder. This often occurs during exercise, heavy lifting, coughing, sneezing and even laughing. Stress incontinence is the most common bladder control problem in young and middle-aged women. In younger women, the condition may be due to an inherent weakness of the pelvic floor muscles or an effect of the stress of childbirth. In middle-aged women, stress incontinence may begin to be a problem at menopause.
Urge incontinence, or overactive bladder (OAB), occurs when a person feels the urge to urinate but is unable to hold back the urine long enough to get to a bathroom. Urge incontinence sometimes occurs in people whove had a stroke or have chronic diseases such as diabetes, Alzheimers disease, Parkinsons diseas, or multiple sclerosis. In some cases, urge incontinence may be an early sign of cancer of the bladder.
Less common types of incontinence include:
What Are the Risk Factors for Urinary Incontinence?
The most common risk factors for incontinence include:
How Is Incontinence Diagnosed?
Urinary incontinence is easy to recognize. The primary symptom most people experience is an involuntary release of urine. However, determining the type and cause of incontinence can be more difficult and require a variety of exams and tests. Most physicians will use the following:
How Does Incontinence Progress?
Different forms of incontinence can appear at different stages of life. Incontinence may be a lifelong condition, it may appear gradually after menopause, or it may appear suddenly as a side effect of another condition or an after-effect of surgery. However, there are some common ways in which various types of incontinence progress.
How Can I Manage My Incontinence?
The treatment of urinary incontinence varies depending on the cause of the bladder control problem. In most cases, a physician will try the simplest treatment approach before resorting to medications or surgery.
Bladder habit training: This is the first approach for treating most incontinence issues. The goal is to establish a regular urination schedule with set intervals between urinations. A doctor will usually recommend starting by urinating at one hour intervals and gradually increasing the intervals between urination over time.
Pelvic muscle exercises: Also called ''Kegel'' exercises (named after the gynecologist, Dr. Arnold Kegel, who developed them), this exercise routine helps strengthen weak pelvic muscles and improve bladder control. The patient contracts the muscles used to keep in urine, holds the contraction for four to 10 seconds, then relaxes the muscles for the same amount of time. It may take weeks or months of regular pelvic exercise to show improvement. Another way to perform Kegel exercises is to interrupt the flow of urine for several seconds while urinating.
Which Medications Are Used to Treat Incontinence?
The drugs prescribed to manage incontinence work by relaxing the bladder muscles to stop abnormal contractions and therefore are most effective for treating urge incontinence. They include:
The side effects of these drugs may include:
Other medications used for incontinence are:
What About Surgery or Implants for Incontinence?
Surgery is sometimes performed to remove a blockage in the bladder or urethra that is causing overflow incontinence or to shift the position of the bladder to remove pressure on it that is causing stress incontinence. The two most common surgical procedures used to treat stress incontinence include sling procedures and bladder neck suspension procedures.
Sacral nerve stimulation is sometimes used to treat overactive bladder (OAB). This treatment involves a surgical procedure to implant a small device below the skin of the buttock. This device periodically generates a mild electrical stimulation to the sacral nerves, which results in increased tension in the bladder, sphincter and pelvic floor muscles.
Are There Products Available to Help Manage Incontinence?
Many people find the following products useful for decreasing incontinence symptoms:
Adult diapers and undergarments
Absorbent, non-bulky pads and underclothing that are worn discretely under clothing are available in different sizes for both men and women. For those with mild or moderate leakage, panty liners are sometimes all that is required.
Patches and plugs
Many women are able to manage light leakage from stress incontinence by using products that block the flow of urine, such as a small, disposable adhesive patch that fits over the urethral opening, a tampon-like urethral plug or a vaginal insert called a pessary.
Catheters
For otherwise unmanageable incontinence, a physician can place a catheter in the urethra to continually drain the bladder. Due to a higher risk of developing infections and kidney stones, catheters are usually a last resort and used only for severely ill patients.
More Information About Incontinence
You can find information about national and local support services and resources for all forms of incontinence and bladder retraining at the following Web sites:
American Urogynecological Society (AUGS)
AUGS is a professional organization for doctors and others who treat and research womens urological conditions.
National Association for Continence
This nonprofit advocacy organization educates the public about the causes, diagnosis, treatment and management of incontinence.
National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC)
This government agency provides information on incontinence and other urologic disorders and supports research on many diseases and conditions.
National Institute on Aging Information Center (NIA)
The NIA has information on incontinence for both patients and clinicians, including downloadable booklets.
Simon Foundation for Continence
The Simon Foundation is a non-profit organization that carries out innovative educational projects, such as the book Managing Incontinence: A Guide to Living with the Loss of Bladder Control and the television movie I Will Manage.
No More Leakage Video Resource
A laugh, a sneeze or a cough used to make Colleen cringe, but a surgical procedure stopped her incontinence.
Source: http://www.everydayhealth.com
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