Urinary Incontinence
Urinary incontinence (involuntary loss of urine, or “leaking”) is a common condition,
afflicting nearly half of all women at some point in their lives. One tenth of women
report regular episodes of incontinence.
Evaluation usually involves a discussion surrounding the circumstances of leaking,
followed by a physical examination and often, a urodynamic evaluation (bladder testing)
in the office.
:: Physiology of normal bladder filling
Normal bladder filling depends on unique elastic properties of the
bladder wall that allow
it to increase in volume at a pressure lower than that of the
bladder neck and urethra (otherwise incontinence would occur).
Despite provocative manoeuvres such as coughing, voluntary bladder
contractions do not occur. Emptying is dependent on the integrity of
a complex neuromuscular network that causes relaxation of the
urethral sphincter a few milliseconds before the onset of the
detrusor (bladder muscle) contraction. With normal, sustained
detrusor contraction, the bladder empties completely.
:: The Types of Urinary Incontinence
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Stress
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Leakage of small amounts of urine during physical movement
(coughing, sneezing, exercising). |
|
Urge
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Leakage of large amounts of urine at unexpected times, including
during sleep. |
|
Functional
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Untimely urination because of physical disability, external
obstacles, or problems in thinking or communicating that prevent a
person from reaching a toilet. |
|
Overflow
|
Unexpected leakage of small amounts of urine because of a full
bladder. |
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Mixed
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Usually the occurrence of stress and urge incontinence together. |
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Transient
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Leakage that occurs temporarily because of a condition that
will pass (infection, medication). |
Women experience incontinence twice as often as men. Pregnancy and
childbirth, menopause, and the structure of the female urinary tract
account for this difference.
But both women and men can become incontinent from neurologic injury,
birth defects, strokes, multiple sclerosis, and physical problems
associated with aging.
The level of incontinence differs for each person and depends upon
the treatments that
they have had, however for some people the phenomena may be short
lived while for a
few it may be permanent.
There has however been a lot of progress in dealing with continence
issues and there
are a wide variety of aids and equipment for collecting urine,
preventing infection and
protecting the skin and surrounding area. There are also a number of
exercises that
can be done to strengthen the urinary sphincter muscle that controls
the opening and
closing of the bladder.
Incontinence is never normal and most of the times it can be
treated. Talk to the incontinence nurse at your local hospital or to
your medical team for advice about the options management of your
continence and the options available to you.
Treatment
Tension-free Vaginal Tape Sling Procedure
Click here to find out more about this surgical
treatment for Stress Urinary
Incontinence.
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