Urinary incontinence : Involuntary passing of urine
Posted Date: 28-Mar-2009
Urinary incontinence or involuntary passing of urine or inability to hold urine is more common in females than in males, there is urination with slight strain like coughing or sneezing, the urine may pass either in drops or with slight stream.
In some cases there may be an intense urge to urinate and the person unable to withold even a slight urge. In some women there may be passing or urine during sexual activity or any emotional stress or if getting a scold at office or college. This is an embarassing situation specially when you are at a public place or with friends or family.
This is crtainly a disorder but curable. In many case it may be due to emotional factors but there are some pathology in most of the cases.
Causes of urinary incontinence
Incontinence occurs because of problems with muscles and nerves that help to hold or release urine. In normal circumstances the urinary bladder contracts and the person feels to urinate but there is a sphincter which relaxes to let the urine pass and remains contracted to hold the urine. In case of incontinence the sphicter is not strong enough to contract and to hold the urine causing incontinence.
As mentioned urinary incontinence is twice more common in females than males, there are many factors associated with it like obesity and urinary tract infection which are very common causes. Other factors associated are pregnancy and child birth, neurogenic disorders like multiple sclerosis, any accident, stroke, menopause or simply ageing.
Types of urinary incontinence
Urinary incontinence can be due to any stress, or inability to hold the urge, it may be without any cause or due to overactive bladder. Each type has it own pathology and symptoms which needs a separate article to discuss. How ever a brief is given about the types of incontinence.
Stress incontinence is involuntary passing of urine in case of any stress like coughing, sneezing or any physical strain like lifting an object or climbing stairs etc. This type of incontinence is treatable and is mostly seen in women and may be due to weakeng of pelvic floor muscles and ligaments which provide a support to bladder.
In prolonged labor there may be any injury which can lead to stress incontinence. Stress incontinence worsens during menstrual period, though it is more frequent in menopausal women.
Urge incontinence is inability to hold urine and sudden urge even when bladder is not full. This is due to inappropriate contraction of the bladder with slightest of stimulus. One may feel the urge even hearing or seeing water falling from tap or a utensil or even a fountain.
Urge incontinence worsen by anxiety or emotional stress, some medical condition like hyperthyroidism may aggravate the situation. In some diseases like multiple sclerosis, Parkinson,s disease, Alzeimer,s disease nerve supplying to bladder may get damaged and there may be involuntary passing of urine.
Overflow incontinence may be due to incomplete evacuation of bladdee leaving high amount of residual urine which later can spill. This may be due to weak bladder as in case of long standing diabetes or any blockage or urethra may be due to stone.
Functional Incontinence occurs in some personswho use to travel for a long distances or any other problems causing difficulties to reach the toilet. For example a patient with severe arthritis hesitate to go to toilet frequently or some patients with some neurogenic diseases like Alziemer,s disease whose mind can't explain to go to toilet in case of feeling a sensation to go to toilet.
Incontinence due to Overactive Bladder
Wrong signal at wrong time is the basic cause of overactive bladder, in some conditions the nerve send a wrong signal to the bladder and it contracts without warning so there is urination without feeling of urge. Some times there may such an intense urge without having sufficient amount of urine in bladder.
In many instances one can observe combined types of incontinence, like in most women stress incontinence and urge incontinence can be seen together.
Most of the incontinence is treatable and a proper history and diagnosis is required to find out the cause.
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