Incontinence

Definition

Inability to control the bladder once the urge to urinate occurs. May occur alone or sometimes with stress incontinence.  Stress incontinence is an involuntary loss of urine during physical activity for example: (involuntary urine loss on coughing, straining, sneezing, etc.)  The prevalence of urinary incontinence increases with age and affects women more often than men.

Signs and Symptoms

Involuntary loss of urine almost immediately after feeling a slight urge to urinate. The volume of lost urine may range from a few drops to complete bladder emptying.

Causes

  • Overactive muscles that cause bladder to contract and empty.
  • A change in the relationship of the uterus to the bladder resulting in shortening of the
    Urethra and the loss of the normal muscular support of the bladder and floor of the pelvis.

Treatment

  • Any underlying cause should be identified and treated.
  • Treatment may involve bladder training techniques, medication, surgery, exercises and use of special aids to ease discomfort.
  • Wear absorbent underpants or superabsorbent pads.
  • A planned schedule for emptying the bladder is helpful. Prompting by a caregiver will help you remember.
  • Keep a daily diary of fluid intake and urination frequency. This will help assess progress.
  • Use bedside commodes, urinals, or bedpans if necessary.
  • A pessary (support device) made of rubber or other material to fit inside the vagina to support the uterus and lower muscular layer of the bladder.
  • Frequently, it is necessary to have urodynamic testing (studies of the actual urine flow), either in the doctor’s office or at a special clinic, to determine the type of incontinence.
  • Surgery to tighten relaxed or damaged muscles that support the bladder.
  • Biofeedback/behavioral training may be recommended.

Medications

There are many medications that are available for the treatment of incontinence, which can be discussed with your medical provider.

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