Urinary incontinence is going when you don’t want to go. It is a big deal because socially it’s just not acceptable and can lead to a lot of psychological stress. If you can’t remember the stages of voiding or the neural control, click here for a refresher.
Types of urinary incontinence
- Stress: it is caused by an increase in intraabdominal pressure (laughing, coughing, sneezing) and a sphincter that can’t contract enough to prevent leakage
- Most common type of incontinence in young women
- Urge: uninhibited contractions of the detrusor muscle, common in older individuals
- Common in older individuals
- Mixed: most common type of incontinence, usually refers to a mix of urge and stress incontinence
- Most common in general
- Overflow: when the bladder is so full it cannot hold in the urine
- Common when there’s an obstruction or spinal cord injury
A handy mnemonic to remember the general causes of incontinence is DRIP
Delirium (drugs, acute illness)
Retention (hypocontractility, outflow obstruction)
Inflammation/Infection/Impacted stool
Polyuria (drugs, high output)
Treatment
- Lifestyle: scheduled voiding, regulating fluid intake, kegel exercises
- Medications to treat underlying cause (especially anti-cholinergics to treat urge incontinence as the detrusor responds to cholinergic stimulation)
- Surgery: Such as tension-free vaginal tape (sling) procedure (TVT) for treating stress urinary incontinence
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