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Definition of Urinary Incontinence and Types
Urinary Incontinence – the involuntary leakage of urine from the urethra. Health experts estimate that as many as 12 million Americans experience some degree of urinary incontinence, which becomes increasingly common with advancing age. There are several types of urinary continence. They include
- stress incontinence, in which urine leaks with activities such as sneezing, coughing, or laughing
- urge incontinence, in which urine leakage accompanies a sudden and overwhelming desire to urinate
- overflow incontinence, in which the bladder fails to send or respond to the normal nerve signals that direct urination and becomes overly full, eventually leaking urine because it can hold no more volume
Causes of Urinary Incontinence
Many people, particularly women past menopause, experience a combination of stress and urge incontinence. This combination form of urinary incontinence develops when the pelvic muscles and ligaments that support the bladder weaken and stretch. Overflow incontinence is more common in older men who have benign prostatic hyperplasia (bph).
The enlarged prostate gland can constrict the urethra, preventing urine from leaving the bladder. Overflow incontinence may also develop in people who have neuropathy of diabetes, long-standing chronic alcoholism, or conditions of the nervous system that affect control of involuntary functions such as multiple sclerosis.
The diagnostic path includes a careful history of the urinary incontinence, blood and urine tests, and possibly diagnostic imaging procedures such as ultrasound or cystoscopy to identify any underlying conditions that could be causing the urinary incontinence.
Treatment may be lifestyle modification, such as altering fluid consumption habits or emptying the bladder on a schedule. Many people, especially women, regain continence with Kegel exercises to strengthen and tone the pubococcygeal muscle that forms the pelvic floor. Incontinence pads and other items help protect clothing from leaking urine.
Sometimes medications to slow the bladder’s response, such as oxybutynin (Ditropan), help ease urge incontinence. In situations that do not improve the urologist may suggest surgery to tighten pelvic muscles or the urethral sphincter.
Though finding the most effective solution may take time, most people are able to successfully manage urinary incontinence.
See also ENURESIS.
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