Urinary incontinence - Causes, Symptoms and Treatment

Urinary incontinence is an inability to hold your urine until you get to a toilet. Some women may lose a few drops of urine while running or coughing. Others may feel a strong, sudden urge to urinate just before losing a large amount of urine. UI can be slightly bothersome or totally debilitating. Stress incontinence may occur as a result of weakened pelvic muscles that support the bladder and urethra, or because of malfunction of the urethral sphincter. Prior trauma to the urethral area, neurological injury, and some medications may weaken the urethra. Urinary incontinence has been reported to affect 35% of American women over 50 years of age an almost 15% who have leakage on a daily basis. Approximately 60% of women with incontinence will have stress incontinence.

Causes

Stress incontinence occurs because of dysfunction in the mechanisms that normally control release of urine from your bladder.
Common causes of urinary incontinence

* For women, thinning and drying of the skin in the vagina or urethra, especially after menopause
* For men, enlarged prostate gland or prostate surgery
* Weakened pelvic muscles
* Certain medicines
* Build-up of stool in the bowels
* Not being able to move around
* Urinary tract infection
* Problems such as diabetes or high calcium levels

Symptoms

SUI symptoms are defined as the accidental leakage of urine during physical activities such as sneezing, coughing, laughing, lifting or exercising, and affect the social and emotional well-being of up to 65 million women worldwide. Swelling results from accumulation of fluid in the tissues (edema). The swelling may cause weight gain. Swelling is usually most noticeable in the ankles and feet, but it may also involve the abdomen, lower back, hands, and face.

Treatment

Brief doses of electrical stimulation can strengthen muscles in the lower pelvis in a way similar to exercising the muscles. Electrodes are temporarily placed in the vagina or rectum to stimulate nearby muscles. This will stabilize overactive muscles and stimulate contraction of urethral muscles. Electrical stimulation can be used to reduce both stress incontinence and urge incontinence.

The cystoscopic examination is a procedure in which a small tube with a telescope attached, is inserted into the bladder so the doctor can look for any abnormalities in the bladder and lower urinary tract. PVR measurement measures how much urine is left in the bladder after urinating by placing a small soft tube into the bladder.

Most stress incontinence results from the bladder dropping down toward the vagina. Therefore, common surgery for stress incontinence involves pulling the bladder up to a more normal position. Working through an incision in the vagina or abdomen, the surgeon raises the bladder and secures it with a string attached to muscle, ligament, or bone.

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