by Gunwant S.Dhaliwal, M.D., Astoria General Hospital, New York
Uncontrolled loss of urine is called urinary incontinence, One out of every 25 Americans, or almost 10 million people, have difficulty controlling their bladder, It can affect People of all ages, but is especially common in women, mostly over age 65.
Causes Urinary incontinence is not a natural part of aging, even though older people tend to suffer more often. Many causes of incontinence are temporary e.g. urinary tract infection, vaginal infection or irritation, constipation and effects of medicine. It can be caused by other condones that are not temporary:
1 Weakness of muscles that hold the bladder in place.
- Weakness of the bladder or its sphincter.
3.Overactive bladder muscles.
4 Blocked urethra (can be from enlarged prostate in men)
5.Hormone imbalance in women.
6.Neurologic disorders.
- Immobility (not being able to move around).
Types: There are many different types of incontinence. Some people have more than one type. Salient features of three common types of urine incontinence are as follows.
1.Urge incontinence: People with urge incontinence loss urine as soon as they feel a strong need to go to bathroom. You may leak urine: When you can’t get to the bathroom quickly enough. When you drink even a small amount of liquid or when you hear or touch running water. go to the bathroom very often e.g. every two hours during the day and night. You may even wet the bed.
2.Stress incontinence: People ‘with Stress incontinence loss urine when they exercise or move in a certain way. You may leak urine: When you sneeze, cough or laugh. When you get up from a chair or get out of bed. When you walk or do other exercise, go to the bathroom often during the day to avoid accidents.
3.Overflow incontinence: People with overflow incontinence may feel that they never completely empty their bladder. You may often lose small amounts of urine during the day and night get up often during the night to go to the bathroom often feel as if you have to empty your bladder but can’t pass only a small amount of urine but feel as if your bladder is still partly full. spend a long time at the toilet, but produce only a weak, dribbling Stream of urine. Tests:
1.Blood tests examine blood for levels of various chemicals.
2.Urinalysis examine urine for signs of infection, blood or other abnormality.
3.Cysstoscopy look for abnormalities in bladder and lower urinary tract. It works by inserting a small tube in to the bladder that has a telescope for the doctor to look through.
4.Postvoid residual (PVR) measurement measure how much urine is left in the bladder after urinating by placing a small soft tube in to the bladder or by using ultrasound.
5.Stress test look for urine loss when Stress is put on bladder muscles usually by coughing, lifting or exercise.
6.Urodynamic testing examine bladder and sphincter function. Treatment: Urinary incontinence is treated in one of more of three ways; behavioral techniques, medication and Surgery. Catheters (tube that is placed in bladder to drain urine in to a bag outside the body) and pads are not the first and only treatment for urine incontinence. They should only be used to make other treatments more effective or when other treatments have failed. I Behavioral techniques: Behavioral techniques (bladder training and pelvic muscle exercises) teach you ways to control your own bladder and sphincter muscles, they are very simple and work well for certain types of urinary incontinence. You may be asked touching the amount of liquid that you drink depending on your bladder problem.
- Bladder training is used for urge incontinence and may also be used for stress information. People learn different ways to control the urge to urinate. Distraction (thinking about other things) is just one example. A technique called prompted voiding (urinating on a schedule) is also used.
- Pelvic muscle exercises are used for stress incontinence to strengthen weak muscles around the bladder.
- Medications: Some people need to take medicine lo treat conditions that cause urinary incontinence. The most common types of medicine treat infection, replace hormones, stop abnormal bladder muscle contractions or tighten sphincter muscles.
- Surgery: Surgery is sometimes needed to help treat the cause of incontinence. It can be used to return the bladder neck to its proper position in women with sires incontinence.
Remove tissue that is causing a blockage. Replace or support severely weakened pelvic muscles.
Enlarge a small bladder to hold more urine,
How well each of these treatment works depends on the cause of the incontinence and, in some cases, patient effort. This information provides a general overview on urinary incontinence and may not apply in each individual case, Consult your physician for determine whether this information can be applied to your personal situation and to obtain additional information.
Article extracted from this publication >> July 30, 1993
