Incontinence

In patients with stress incontinence, urine may leak out even though they are doing physical activities, like coughing, laughing, walking, or lifting heavy objects. This type of incontinence is not affected by mind-body pressure, but rather on physical pressure on the bladder. Urinary incontinence is the most frequent sort of incontinence. Weak pelvic muscles are usually the main cause, supporting the bladder, bladder neck and urethra. Usually the problem stems from weak pelvic muscles, which result from childbirth, pregnancy and surgery on the pelvic area. Additionally, an impaired urethral sphincter muscle may cause stress urinary incontinence in females, and both conditions may occur at the same time.

An individual struggling with incontinence has an issue maintaining control of the sphincter muscle responsible for urination. This condition is caused by an overactive bladder, which causes a startling and immediate urge to pee, followed by uncontrollable urination. Incontinence is frequently associated with the conditions diabetes, stroke, dementia, Parkinson s disease, multiple sclerosis, and can also be an indicator of early bladder cancer in men. In men, it can be a sign of an enlarged prostate, however, it can also occur in otherwise healthy older individuals as well.

On the other hand, summoned incontinence is the leakage of small amounts of urine from a bladder that remains full. Such incontinence occurs when the bladder is mostly allowed to overflow during use, causing weak urine flow with a perky or constant dribble. It can occur when the flow of urine from the bladder is blocked or if there is impaired bladder direction in one’s body due to some form of diabetes and due to bladder muscle weakness.

Many mature individuals who see adequate urination patterns frequently have physical urination troubles.
Bladder incontinence is the complete loss of bladder control after some sort of surgery to the lower urinary tract.

For stress incontinence, treatment options depend on the severity of the condition. Mild cases can often be improved with pelvic floor muscle exercises, also known as Kegel exercises. In more severe cases, surgery may be recommended to repair weakened pelvic muscles or the urethral sphincter.

For urge incontinence, the first step in treatment is often behavior modification, such as timed voiding and reducing fluid intake. Pelvic muscle exercises may also be helpful. Medications known as bladder specific anticholinergics can be used to relax the bladder and prevent involuntary contractions, but they may cause side effects such as dry mouth, constipation, or changes in vision. In more difficult cases, a procedure called augmentation cystoplasty may be recommended to increase the size of the bladder. Botox injections to the bladder are also an option for those who do not respond to medications or experience intolerable side effects. The downside is that the injections may need to be repeated every 6-9 months.

To diagnose urinary problems, several tests may be performed. The first is a urinalysis, which checks for infection, blood, or other abnormalities in the urine. Another test is uroflowmetry, which measures the rate and amount of urine flow. This test is done by sitting on a modified toilet seat and passing urine into a flow meter.

To determine whether any urine remains after attempting to empty the bladder, a residual urine measurement is done using a bladder scanner. To avoid inaccurate results, our hospital does not perform uroflowmetry and residual urine measurement together. Instead, we recommend that patients do these tests separately by filling their bladder once for uroflowmetry and then again for pre- and post-void measurements.

In the event that uroflowmetry and/or residual urine tests show abnormalities, further evaluation may be needed through a voiding cystometry (Urodynamics) to identify the underlying cause of difficulty in urination. These are specialized outpatient tests that evaluate the normal and abnormal function of the urinary tract, such as the bladder and urethra. The level of complexity of the tests varies based on the specific issue being addressed.