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Urinary Incontinence

urinary incontinenceUrinary incontinence is characterized by involuntary loss of urine which may cause social, hygienic or health problems. The loss of urine may associated with physical activity, strong desire to void, or overflowing of the bladder. Incontinence of urine is generally more common in women.

Urinary incontinence is one of the most distressing and embarrassing disorders because individuals do not have control of their urine passage mechanism.

They pass urine unintentionally. For instance, they occasionally experience urine leaks after coughing, laughing and sneezing. On the same hand, they may experience a sudden and very strong urge of urinating, which they do, before reaching the toilet. Under such circumstances, if they fail to visit the toilet immediately, they urinate on themselves. As a result, the disorder has a profound impact on their social life as well as well being.

Urinary incontinence is very common, especially in the developed countries. In fact, it is estimated that approximately 50 million of the population residing in developed countries suffer from this predicament. Medical research conducted in UK indicates that about 13% of women and 5% of men suffer from this disorder. From the gathered results, it is evident that the disorder is more common in women than men since the results show a ratio of two is to one respectively. In addition, this disorder is more prevalent in older adults. In fact, about 35% of the older population (aged 60 years and above) suffers from this disorder.

However, this figure is a speculation because a higher percentage of individuals suffering from the disorder do not seek medical attention. This is because they feel embarrassed to talk about the situation. On the other hand, there is a myriad of ways used to define the disorder. Therefore, knowing the exact number of individuals suffering from the condition is difficult. The most common types of the disorder include stress and urge incontinence.

Stress incontinence occurs when the pelvic floor muscles loss their elasticity and thus are too weak to holds urine when the bladder is under pressure. These are the muscles that keep the bladder closed. This is what happens when individuals leak urine after laughing, coughing, sneezing, climbing stairs, exercising or lifting a heavy load. Also, the pelvic floor muscles can become weak when they are overstretched for instance by rapid weight gain, diabetes and childbirth.

The latter disorder occurs when urine leaks out uncontrollably while at the same time, individuals experience an intense urge of urinating. Individuals get this feeling often and on the downside may soak their clothes because they leak a large amount of urine. This also happens when the bladder contains a very small amount of urine. In addition, this can happen when the pelvic floor muscles stimulate the urge of urinating because it is overactive. This condition is normally referred to as overactive incontinence.

The over activeness may be triggered by emotional stress, bladder irritation, multiple sclerosis, spinal cord injury, spina bifida, stroke and Parkinson’s disease just to mention but a few. There is also a possibility of one suffering from the two types of the disorder simultaneously. Such a condition is commonly referred to as mixed urinary incontinence. Other causes of the disorder may include nerve damage, use of certain medicines, constipation, urinary tract infection, and prostrate problems. Also, over dependence of caffeine and cola can contribute to development of urinary incontinence.

So how does one get rid of this embarrassing situation? The treatment of urinary incontinence depends on a plethora of factors including ones lifestyle, results from the clinical tests and the type of problem triggering the disorder. Usually, patients suffering from this disorder are placed under a basic evaluation for their medical history to detect a common patter of urine leakage and voiding. This helps in determining the type of urinary incontinence the patients are suffering.

Moreover, urologists can gather prudent facts like illnesses that individuals have suffered, the type of drugs that they have used or are using, if they have ever had surgery or if they are facing any strenuous phase. These factors may be the underlying cause of the predicament. In addition, tests such as urinalysis, cystoscopy, physical examination, blood test, ultrasound, cotton-swab test, urodynamic studies, measurement of postvoid residual urine volume (PVR) and cough stress are also conducted.

The physical examination enables the urologists to detect any medical conditions like tumors, poor reflexes and stool impaction that may trigger the disorder. Furthermore, the patients are supposed to record the amount of urine they pass and their pattern of voiding in a day. The gathered data plays a crucial role in determining the type of urinary incontinence a patient is suffering. Those suffering from intense symptoms are placed under a videourodynmic study.

Management Of Urinary Incontinence

According to the diagnostic results, urinary incontinence patients may be subjected to behavioral management, surgery, conservative or medical treatment. Behavioral management may entail training the bladder to hold urine for a long period of time. This is mainly done by delaying to urinate after getting the urge to do so. Individuals can begin by trying to hold the urine in their body for about 10 minutes and gradually increase the duration. This should be done until individuals are able to separate their trips to the toilet with two to four hours.

Breathing deeply and slowly as well as distracting oneself can help individuals delay urination. Alternatively, individuals can train their bladder via double voiding. They should try to urinate again immediately after they urinate. In the process, they will train their bladder to fully empty the urine. Behavioral management may also include fluid and diet management as well as scheduled toilet trips.

On the other hand physical/ conservative therapy entails doing pelvic floor muscle exercises (kegel exercises) to strengthen the urinary sphincter and the pelvic floor muscles. Also, the pelvic floor muscles can be strengthened via electrical stimulation. Usually, electrodes are placed into the vagina or rectum on a temporal basis to stimulate the muscles and in the process strengthen them.

On the other side, medicines such as anticholinergics, topical estrogen, duloxetine and imipramine are used to treat urinary incontinence. At other times, medical devices such as urethral insert and pessary are placed into the vagina or rectum to treat the disorder. Surgery is usually the last option. It is mainly used to treat intense conditions. The surgical procedures used include bladder neck suspension, sling procedures and artificial urinary sphincter. The procedures are aimed at strengthening the pelvic and urethra muscles so as to enable individuals control urination.

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