Types Of Urinary Incontinence
Stress Incontinence
Stress incontinence
is particularly common in women (rare in men), and is characterized
by sudden leakage of urine in response to stress. The leakage of
urine is worse during the day. Instantaneous leakage of urine which
occurs with coughing is suggestive of stress incontinence. This
condition if severe, is often treated with surgery, while mild to
moderate cases benefit from pelvic muscle exercise. Some cases are
also treated with alpha-adrenergic agonist ( if not contraindicated)
and estrogen. Tampon may provide some relief.
Urge Incontinence
This type of urinary incontinence is caused by involuntary bladder
detrusor muscle contraction without any neurological disorder. It is
the commonest form of urinary incontinence in the elderly
population. It is characterized by leakage of urine caused by
intense and sudden desire to urinate that brooks no delay.
Individuals with urge incontinence may also experience increased
frequency of urination, and waking up to urinate at night. Careful
evaluation should be done to rule out bladder stones as this may
also cause detrusor instability. Several other conditions may predispose to
this condition and few of these include Parkinson's disease,
Alzheimer's disease, spinal cord injury or multiple sclerosis. Urge
incontinence may also be referred to as unstable bladder or
hyperreflexic bladder. The main emphasis of treatment is
behavioral therapy. Use of medications for this condition are
carefully monitored, as they may precipitate urinary retention.
Overflow Incontinence
Overflow incontinence occurs with over distension of the bladder
which may result from obstruction ( e.g. with prostate enlargement).
The over distention of the bladder leads to constant dribbling or
leakage of urine. Other causes of obstruction to urinary flow
include; urethral stricture and fecal impaction. Conditions such as
diabetes, syphilis, and spinal cord compression result in hypotonic
bladder and subsequently cause bladder distention and overflow
incontinence. Generally, the treatment of choice is to correct the
underlying cause.
Neuropathic
Congenital
Fistulous
Traumatic
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