Urinary incontinence

Description, Causes and Risk Factors:Alternative Name: UI.Alternative Names: Bladder incontinence, uncontrollable urination.Urinary incontinence is the involuntary loss of urine. Urinary incontinence affects more than 25 million Americans, including cancer survivors. Because urinary incontinence involves such a personal and private matter, it can cause embarrassment and negatively affect your self-esteem, lifestyle and quality of life.The urinary bladder stores urine produced by the kidneys until time to empty the bladder. It is a muscular organ that expands as it fills with urine. Urine stays in the bladder until nerves from the bladder send a message to the brain, telling it that your bladder is full. The brain sends a message back to the bladder to release the urine. The muscles (detrusor muscle) supporting the bladder are called pelvic floor muscles. These muscles create a valve that opens or closes to release or hold urine. These muscles may stretch and weaken and be unable to close completely, allowing urine to leak (urinary incontinence).Incontinence is most common among the elderly. Women are more likely than men to have urinary incontinence.Common Causes of Urinary Incontinence May Include:
  • Sagging of the pelvic organs such as a prolapsed uterus or bladder.
  • Weakening of the pelvic muscles, bladder and/or urinary sphincter muscles from pregnancy, childbirth and menopause.
  • Tissue injury from hysterectomy, prostate surgery or radiation treatment for prostate cancer.
  • An enlarged or inflamed prostate gland in men can make it difficult to urinate.
  • Nerve damage from diabetes, stroke, Parkinson's disease, multiple sclerosis, and spinal cord injury.
  • Certain medications such as sleeping pills, diet pills, diuretics (water pill), muscle relaxants, antidepressants, heart/blood pressure medications, allergy/cold medicines.
  • Excessive intake of alcohol and/or caffeine (tea, coffee, chocolate, cola).
  • High impact or vigorous exercise.
  • Obesity.
  • Pregnancy.
  • Chronic constipation.
  • Urinary tract infection.
  • Uterine fibroids.
Types of cancers that lead to urinary incontinence may include:
  • Cancers in the pelvis such as prostate, cervix, rectum, urethra, and bladder.
  • Tumors of the brain, spinal cord or those affecting the nerves to the bladder or pelvic muscles.
  • Lung or esophageal cancer.
  • Breast cancer.
Symptoms:Different types of urinary incontinence have different symptoms.
  • People with stress incontinence experience leaking urine with laughing, coughing, sneezing, lifting, exercising or standing up.
  • People with urge incontinence may have overactive bladder and responds by signaling the need to urinate even though little urine is in the bladder.
Diagnosis:Your PCP (primary care physician) will take a careful medical history; perform a physical exam (including pelvic and/or rectal exam), and a urine analysis to check for infection or abnormalities.Usually a urinalysis and cough stress test will be conducted at the ?rst evaluation. If some ?ndings suggest further evaluation, other tests may be recommended — such as a cystoscopy or even urodynamic testing. This outpatient test is usually done with a tiny tube in the bladder inserted through the urethra and sometimes with a small rectal tube, as well.In some cases, a referral may be made to an urologist (a specialist in diseases of the urinary tract) or a gynecologist (a specialist in the female reproductive system) for further evaluation.Treatment:Treatment for urinary incontinence depends on the type of incontinence, the severity of your problem and the underlying cause. Many successful options for treating urinary incontinence exist. Options include behavioral therapy, medications, and surgery.Behavioral techniques and lifestyle changes work well for certain types of urinary incontinence. They may include:
  • Bladder retraining: This involves urinating on a schedule, whether you feel a need to go or not. In between those times, you try to wait to the next scheduled time. At first, you may need to schedule 1-hour intervals. Gradually, you can increase by 1/2-hour intervals until you are only urinating every 3 - 4 hours without leakage.
  • Kegel exercises: Contract the pelvic floor muscles for 10 seconds, then relax them for 10 seconds. Repeat 10 times. Do these exercises three times per day. You can do Kegel exercises any time, any place.
  • Biofeedback: Used in conjunction with Kegel exercises, biofeedback helps people gain awareness and control of their pelvic muscles.
  • Pelvic floor electrical stimulation: Mild electrical pulses stimulate muscle contractions; should be performed in conjunction with Kegel exercises.
Often, medications are used in conjunction with behavioral techniques. Drugs commonly used to treat incontinence may include, anticholinergics, topical estrogen, and Imipramine. Medical devices may include urethral inserts, pessary.If the incontinence is related to structural problems such as an abnormally positioned bladder or a blockage surgery may be needed.Disclaimer: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care. 

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