Urinary Incontinence

The complaint of any involuntary leakage of urine is called as urinary incontinence. It is a common and often embarrassing problem which may lead to marked deterioration in self esteem of some females. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time. Bladder symptoms affect women of all ages. Almost one third of females above 60 years of age suffer from urinary incontinence. Women over the age of 60 years are twice as likely as men to experience incontinence due to weakening of pelvic musles during pregnancy.

TYPES OF URINARY INCONTINENCE

Stress urinary incontinence:

It is due essentially to insufficient strength of the pelvic floor muscles to prevent the passage of urine, especially during activities that increase intra-abdominal pressure, such as coughing, sneezing, laughing,jumping etc. It is the most common type of incontinence in women

Urge urinary incontinence:

It is the involuntary leakage of urine accompanied by or immediately preceded by urgency..Older women usually have mixed incontinence and urge incontinence predominantly

Overflow incontinence:

Sometimes people find that they cannot stop their bladders from constantly dribbling or continuing to dribble for some time after they have passed urine

Functional incontinence:

It occurs due to factors unrelated to physiological voiding mechanism.

Management:

If the leakage is distressing to the patient,evaluation and treatment should be offered. Incontinence can almost always be improved and frequently can be cured usually using simple techniques.Treatment options range from conservative treatment, behaviour management, bladder retraining, pelvic floor therapy. Weight loss is recommended in those who are obese.

Exercises and bladder training

Pelvic floor muscle training ( Kegel exercises ) is an effective treatment for women with stress incontinence.] Efforts to increase the time between urination, known as bladder training, is recommended in those with urge incontinence. Both these may be used in those with mixed incontinence.

Medications

A number of medications exist to treat incontinence,although they do have their own side effects. Anticholinergic agents can be used to treat those who have urge incontinence who do not improve with bladder training.

Surgery

Surgery may be used to help stress or overflow incontinence. Common surgical techniques for stress incontinence include slings, tension-free vaginal tape, trans obturator suburethral tape.