Q- What is urinary incontinence?
Ans- Urinary incontinence
is the inability to hold urine leading to involuntary loss of urine. The urine
loss can range from slight leakage of urine to severe frequent wetting. This
condition severely affects quality of life by interfering with work, travel,
social recreation and sexual activities.
Q- What is the incidence of of urinary incontinence?
Ans- At least 10% of
people over the age of 65 years have urinary incontinence. According to World
Health Organisation estimates, there are 200 million patients worldwide with
symptoms of male or female urinary incontinence. However, as this condition is
associated with shame, embarrassment and silence, the exact figure is not
known.
Q- Is urinary incontinence an inevitable part of aging?
Ans- With aging, the urge
to urinate may occur more frequently and be harder to control: however,
incontinence can affect men and women of all ages and is not a normal response
to aging.
Q- Is the incidence of urinary incontinence similar in men and women?
Ans- No, women experience
incontinence two times more often than men. Pregnancy and child-birth,
menopause and the structure of the female urinary tract account for this
difference. However, both women and men can become incontinent from stroke,
multiple sclerosis and other physical problems associated with old age.
Q- What are the risk fators for urinary incontinence?
Ans- Risk factors for
urinary incontinence vary, but include:
1.
Pregnancy
2.
Childbirth
3.
Obesity
4.
Menopause
5.
Cigarette smoking
6.
Prostate enlargement and/or surgery
7.
Hysterectomy
8.
Radiation therapy to the pelvis
9.
Diabetes
10.
Parkinson's disease
11.
Back injury
12.
Cerebral vascular accident
13.
Dementia.
Q- Are
there different types of urinary incontinence?
Ans- There are three
basic types of urinary incontinence :
1.
Urge incontinence
2.
Stress incontinence
3.
Overflow bladder
Q- What is urge incontinence?
Ans- Urge incontinence or
detrusor over activity is a common problem that increases in frequency and
severity with advancing age. In this condition, the patient often loses urine
for no apparent reasons while suddenly feeling the need or urge to urinate. In
urge incontinence, the bladder involuntarily empties during sleep, after
drinking a small amount of water, or while touching water or even when hearing
it run (as when someone else is taking a shower or washing dishes).
Q- What
causes urge incontinence?
Ans- The most common
cause of urge incontinence is inappropriate and involuntary bladder
contractions. These involuntary contractions may occur because of inflammation
or irritation within the bladder or when certain neurological diseases impair
control of bladder contractions.
1.
Urinary tract infections
2.
Cancer
3.
Parkinson's disease
4.
Alzheimer's disease
5.
Certain drugs such as hypnotics or
narcotics
6.
Injury (such as those occurring during
surgery)
7.
Benign prostatic hyperplasia (BPH).
Urge incontinence can also occur when
mobility is impaired (for example, in patients with arthritis), making it
difficult for patients to get to the bathroom in time. This condition is
sometimes referred to mass "functional" incontinence.
Q- What is stress incontinence?
Ans- Stress incontinence
is the most prevalent form of incontinence in elderly patients. It is caused by
malfunction of the urethral sphincter that causes urine to leak from the
bladder when intra-abdominal pressure increases, such as during laughing,
coughing or sneezing.
Q- What causes stress incontinence?
Ans- Physical changes
resulting from pregnancy, childbirth and menopause are common causes of stress
incontinence. It is the most common form of incontinence in women and is
treatable. Certain muscles, known as the "pelvic floor muscles"
support the bladder. If these muscles weaken, the bladder can move downward,
pushing slightly out of the bottom of the pelvis toward the vagina. This
prevents muscles that ordinarily force the urethra shut from squeezing as
tightly as they should. As a result, urine can leak into the urethra during
moments of physical stress. Stress incontinence also occurs if the muscles that
do the squeezing weaken. Stress incontinence can worsen during the week before
menstrual period. At that time, lowered estrogen levels might lead to lower
muscular pressure around the urethra, increasing chances of leakage. The
incidence of stress incontinence increases following menopause. Stress
incontinence can also occur as a result of drugs, Surgical trauma or radiation
damage.
Q- What is overflow incontinence?
Ans- Overflow bladder is
usually seen in elder men. Urinary incontinence due to overflow bladder is more
common in men because of the prevalence of obstructive prostate gland
enlargement. In this condition urine accumulates in the bladder until maximum
bladder capacity is reached. It then leaks through the urethra by
"overflow", usually manifesting as dribbling. However, increased
intra-abdominal pressure, which occurs during coughing and sneezing, may also
cause loss of urine, so that overflow incontinence may be confused with stress
incontinence.
Q- What causes overflow incontinence?
Ans- Overflow bladder
incontinence occurs because of:
1.
Week bladder muscles caused by nerve
damage from diabetes or other diseases (e.g., tumours, radiation, surgery)
2.
Obstructed urinary outflow, such as
those caused by prostate enlargement and urinary stones
3.
Under active bladder contractions
caused by certain medications. These medications lead to urinary retention with
bladder distension.
Q- Are there any other types of incontinence?
Ans- When stress and urge
incontinence occur together, it is sometimes referred to as "mixed
incontinence". This is common in women. "Transient" or temporary
incontinence can be caused by medications, urinary tract infections, mental
impairment, restricted mobility and severe constipation, which can push against
the urinary tract and obstruct outflow.
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