Urinary And Stress Incontinence - It's Treatment
Alternative names :- Loss of bladder control; Uncontrollable urination; Urination - uncontrollable; Incontinence - urinary
Urinary incontinence is defined as the involuntary loss of urine. It occurs if bladder muscles suddenly contract or muscles around the urethra suddenly relax. Stress incontinence is the loss of urine as a result of physical activity. Urinary incontinence occurs in men and women, but the prevalence in women is two times greater, occurring in 15% to 30% of women. Stress incontinence, the most common form in women. is believed to account for one-half of all cases of urinary incontinence in women. Older women are more likely to suffer from urinary incontinence than younger women
What causes Urinary incontinence?
Pregnancy and childbirth. menopause. and the structure of the female urinary tract contribute to the increased incidence of urinary incontinence in women. After pregnancy and childbirth. pelvic floor muscles may weaken. These are the same muscles that squeeze around the urethra to make it close. Decreased levels of estrogen also lead to lower muscular pressure around the urethra. As a result. complete closure of the urethra may not occur, or may not be maintained during physical activity. Urinary incontinence has also has been linked to hormone replacement therapy.
Other factors that may cause or contribute to urinary incontinence include:
Signs and symptoms of Urinary incontinence
Leakage of urine is the major sign of urinary incontinence. Urinary incontinence is also associated with nocturia, frequent urination (more than 8 times in 24 hours), and the sudden, uncontrollable urge to urinate moderate or large amounts of urine. Stress incontinence is usually associated with loss of small amounts of urine while coughing, laughing, sneezing, jogging, lifting, and other movements that put pressure on the bladder. It may worsen during the week before menses, and commonly increases after menopause. Frequency and nocturia aren't common symptoms of stress incontinence.
Urinary incontinence and stress incontinence have also been associated with:
The Types of Urinary Incontinence
Diagnostic tests used to evaluate urinary incontinence include:
Treatment of Urinary incontinence
Treatment strategies for urinary incontinence should always begin with the least invasive method. Commonly, a less invasive method is successful and more invasive techniques such as surgery can be avoided. It's important to note that noninvasive techniques require participation and commitment from the patient. These techniques include:
Pharmacologic agents can also be used to treat urinary incontinence associated with detrusor instability. Anticholinergics, such as oxybutynin (Ditropan) and tolterodine (Detrol), block involuntary contractions of the bladder. Tricyclic antidepressants, such as imipramine (Tofranil), exert anticholinergic and musculotropic effects. They also increase bladder outlet resistance. Hormones, such as estrogen, help muscles function normally and are effective in treating postmenopausal women with stress incontinence.
In some instances, more invasive treatments may be necessary to relieve the condition. These include:
Special considerations and Prevention
It's important for health care proViders to screen patients, especially women, for urinary incontinence. Patients may be too embarrassed to admit their symptoms. Reassure patients that it's a common disorder and typically can be treated with fairly conservative measures. In addition:
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