What is Urinary incontinence?
The involuntary leakage of urine is termed as incontinence. Simplistically speaking, it means the person is unable to control their urge to urinate and there is dribbling of urine.
Urinary incontinence is one of the most common complaints reported by American Urological Association. One quarter to one third of the population suffers from urinary incontinence worldwide. Urinary incontinence is more common in women than men. The projected age group that suffers with this condition lies between 30-60 yrs. 30 % of females suffer from incontinence while 1.5-5 % of men experience this problem.
Types of incontinence:
1. Stress incontinence
This is one of the most common types of incontinence. This is usually seen in woman who have given birth or gone through menopause. “stress” in this case refers to the physical pressure. The bladder muscles involved in urinary control when placed under sudden extra pressure, leads to urine dribbling involuntarily.
The following actions may trigger stress incontinence:
- A sudden cough
- Heavy weight lifting
- Heavy Exercise.
2. Urge incontinence (effort incontinence)
This condition is also called as overactive bladder. This is the 2nd most common type of urinary incontinence. In this case, there is sudden, involuntary contraction of the bladder muscles leading to a sudden leak of urine. The urge to urinate is very short lived leading to uncontrolled urinary outflow. This urge may be caused due to following reasons:
- A sudden change in position.
- The sound of running water (for few people)
- Sex (especially while orgasm).
The bladder muscles do not function to its optimum level due to weak bladder muscles, improper nervous system or damaged muscles or nerves themselves.
3. Overflow incontinence
This is more common in men with prostate problems, a damaged bladder or a blocked urethra. An enlarged prostate gland can obstruct the bladder.
- The problem usually is either the body is making more urine than what the bladder can hold causing it to leak or the bladder is unable to empty the urine completely. The patient will usually complain of urinating frequently or will experience dribbling or a constant dripping of urine from the urethra.
4. Mixed incontinence
In this condition, the patient experiences both stress incontinence and urge incontinence at the same time.
5. Functional incontinence
This condition refers to person who knows there is a need to urinate, but is unable to make it till the bathroom due to mobility issues. The most common causes include:
- Poor eyesight
- Poor mobility
- Poor dexterity (cannot unbutton pants in time)
- Depression, anxiety or anger (unwilling to go to the toilet)
This kind of incontinence is more prevalent among the elderly population.
6. Gross total incontinence
This means the person experiences leakage of urine continuously or has a periodic uncontrolled leakage of the amount of urine. This can be due to congenital problem (birth defects), or there may be an injury to the spinal cord or urinary system, or there may be a fistula (hole) between the bladder or for example vagina.
Risk Factors for urinary incontinence:
- Gender: ladies are more prone to have stress in continence post pregnancy.
- Old age
- Some diseases or health conditions like diabetes, kidney disease, spinal cord injury or neurological diseases. For instance stroke or head injury.
- Prostate disease
Diagnosis of Urinary Incontinence:
- By maintaining a bladder diary: note down the amount of fluids taken in and the amount of frequency of urination and the number of episodes of incontinence.
- Physical examination:
In women: pelvic floor muscle strength and vaginal examination is done.
In men: the rectum may be checked to detect in enlargement of prostate gland leading to incontinence.
- Urinalysis: analysis to detect infection and abnormalities
- Blood test: to assess kidney function
- Post-void residual (PVR) measurement
- Pelvic ultrasound
- Stress test
- Urodynamic testing
- Cystogram: x-ray to visualize the bladder.
Treatment for urinary incontinence:
- For stress incontinence
- Bladder training
- Medications for urinary incontinence
- Medical devices