Urinary Incontinence

Urinary incontinence is a condition in which there is an involuntary loss of urine to an extent that it becomes a social or hygienic problem. It is estimated that 20-40% of the female population will experience incontinence in their lifetime. Risk factors for incontinence include: gender (2-3 times more common in women than in men), childbirth, menopause, smoking, and obesity.

Types of Incontinence

Stress Incontinence: Incontinence that occurs during activities that increase intra-abdominal pressure such as sports, lifting, coughing.

Urge Incontinence (Overactive Bladder): Incontinence that occurs due to uninhibited bladder contractions or spasm. (Example: Someone feels a sudden need to void but is unable to hold their urine until they can make it to a bathroom.)

Overflow Incontinence: Incontinence that occurs when the bladder fills to capacity and intermittently spills urine. This occurs in patients with certain neurologic conditions or advanced diabetes who are unable to feel when their bladder is full.

Mixed Incontinence: Incontinence that occurs when a combination of the above mechanisms are in action in a single patient.

Treatment of Incontinence

Treatment is based on the cause of incontinence. Conservative measures such as bladder training and biofeedback are useful in the treatment of urge incontinence, which also responds very well to medical therapy. Pelvic floor exercises (Kegel maneuvers, biofeedback, electrical stimulation) can be used to treat stress incontinence which is not very responsive to medical therapy. Incontinence surgery (laparoscopic or vaginal procedures which raise the bladder neck- blocking the loss of urine due to increased abdominal pressure), although not useful in the treatment of urge incontinence, these procedures are very effective in the treatment of stress incontinence.

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