Urinary Incontinence
- Urinary incontinence (commonly known as after-dribble) can occur when the muscles that surround the urethra do not contract properly. This stops the bladder from fully emptying.
Symptoms:-
- Difficulty starting the flow of urine
- Strain to empty the bladder
- A slow urine stream when emptying bladder
- feeling the need to urgently empty bladder
- burning,discomfort or pain when emptying bladder
- blood-stained urine
- Frequent urination in nightnigh etc.
Causes:-
Temporary or short-term causes of incontinence can include:-
- Urinary tract infections (UTIs)
- Pregnancy:- During pregnancy, your uterus places extra pressure on the bladder as it expands.,and hence PMD is triggered.
- Medications: Incontinence can be a side effect of certain medications, including diuretics and antidepressants.
- Constipation:- Chronic constipation can cause you to have bladder control issues.
- Beverages: There are certain drinks — like coffee and alcohol — that can make you need to urinate much more often.
Chronic or long term causes of PMD:-
- PMD is due to weakness of the muscles of the pelvic floor which surround the urethra.
- Stroke: A stroke can cause you to experience issues with muscle control. This can include the muscles that control your urinary system.
- Diabetes: When you have diabetes, your body produces more urine. This increase in the amount of urine can cause leakage issues.
- Menopause: Menopause is another time of change in a woman’s body when hormone levels change rapidly and pelvic floor muscles can also become weaker — something that also can happen as you get older.
- Multiple sclerosis (MS): If you have MS, you may experience a loss of control with your bladder, leading to leakage issues.
- Enlarged prostate: When the prostate is larger than normal, it can cause several bladder control issues. Eg:-BPH.
Types:-
There are several different types of incontinence. These types have different causes, characteristics and triggers for urine leakage. Knowing the type of incontinence is often an important part of the diagnosis and treatment plan for incontinence.
The types of incontinence include:-
- Urge incontinence:-This type of incontinence is characterized by an intense need to urinate right away.
Urge incontinence can be caused by a condition called Overactive Bladder (OAB).
- Stress incontinence: When you leak urine during activities(Such as laugh, cough, sneeze, run, jump or weight lifting etc) this is often stress incontinence.
Men who have had prostate surgery and Women who have given birth are at a higher risk of having stress incontinence.
- Overflow incontinence: If your bladder doesn’t empty completely each time you urinate, you could have overflow incontinence.
This type of incontinence is more common in people with chronic conditions like multiple sclerosis (MS), stroke or diabetes. This may also occur in men with a large prostate.
- Mixed incontinence: This type of incontinence is a combination of several problems that all lead to leakage issues.
Investigations:-
- Physical Examination
- Urine analysis test
- Urodynamics
- USG of bladder
- Cystoscopy etc.
Treatment:-
There are many different factors that your healthcare provider will consider when creating a treatment plan for your incontinence.
There are three main types of treatment for incontinence — medications, lifestyle changes and surgery.
- Medications to treat incontinence:-
There are quite a few medications that can reduce leakage. Some of these drugs stabilize the muscle contractions that cause problems with an overactive bladder.
- Lifestyle changes to manage incontinence:-
Lifestyle changes to help improve incontinence can include:-
- Emptying your bladder on a regular schedule. This is also called timed voidings.
- Emptying your bladder before physical activities such as excercise etc.
- Avoiding lifting heavy objects.
- Avoide drinking caffeine or a lot of fluids before staring an activity.
- Maintaining a healthy body weight.
- Procedures and surgeries to treat incontinence:-
- Bulking agents: This treatment option is an injection that’s typically used in women with stress incontinence. A permanent substance is injected into the lining of your urethra to help increase the size of the urethra’s lining.
- Botulinum toxin injections (Botox®):- Patient might think of Botox® as a cosmetic treatment, but it can also be used to relax muscles in your body.
- Neuromodulation devices:- Pacemakers that stimulate the nerves to the bladder to improve control can be implanted. Furthermore, a nerve near your ankle can be stimulated to achieve better bladder control
- Artificial urethral sphincter: This is a device that’s used in men with stress incontinence that is placed to close the urethra when not urinating. It’s typically used for leakage after prostate cancer surgery.
