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Urinary incontinence is the condition of unwanted or uncontrolled leakage of urine. Urinary incontinence is not a disease, it is a symptom. This problem is very common in people of almost every age group. The problem is very distressing and has a bad impact on quality of life suffering from urinary incontinence. Most of the times due to embarrassment patient do not consult with their doctors. In general, cases urinary incontinence is curable but due to ignorance, the problem can grow bigger. The treatment of incontinence depends upon the type of incontinence there are many different type and causes of incontinence. For treatment, we have to first identify the etiology of incontinence. There are generally two type of incontinence first one is temporary incontinence that is caused by certain food habits, medication and drinks. A simple change can bring relief from this problem. Another one is persistent urinary incontinence caused some physical problem and change. The primary cause for urinary incontinence is Bladder Dysfunction and Urethral Dysfunction. These two reason leads to the different types of incontinence. Bladder Dysfunction: Overflow incontinence and urge incontinence are caused due to bladder dysfunction. Bladder dysfunction occurs nerve signal in areas of the central nervous system that control bladder urinary sphincter are blocked by MS lesion. The sphincter is the muscle surrounding the opening of the bladder that controls the storage and outflow of urine. This muscle gives people voluntary control over urination. The symptoms of bladder dysfunction can include: • Frequency and/or urgency of urination • Hesitancy in starting urination • Frequent nighttime urination (known as nocturia) • Incontinence (the inability to hold in urine) These symptoms can be caused by a spastic bladder that is unable to hold urine for normal amount of time, or by a bladder that does not empty properly and retains some urine in it. Retaining urine can cause damage to kidney also. Urge Incontinence: Urge incontinence is a form of urinary incontinence that is caused due to bladder dysfunction. In urge incontinence, the patient feels a sudden need or urge to urinate. An appropriate detrusor muscle contractions cause’s urge incontinence. Patient suffering from urge incontinence can incontinent while sleeping, after drinking little amount of water and even when they touch water. in urge continence bladder gets elevated and due to that bladder neck and urethra gets opened up. This elevation may occur from intermittent bladder contractions or because of incremental rise in pressure with increased bladder volume. A patient with urge incontinence is unable to full suppress the sudden sensation. In some severe cases even patient is not aware of sensation of needing to void until they are actually leaking. The amount of leakage depends upon the patient’s ability to suppress the contraction. Overflow Incontinence: This is occurred when bladder is not able to fully empty. Overflow incontinence occurs when bladder volume reaches the limit of the bladder’s viscoelastic properties. It may also occur when Overflow when bladder stops contracting to medication, nerve injury or chronic over stretching of bladder muscles. Incontinence can be caused by Epidural anesthesia and delivery also. Symptoms of Overflow Incontinence are dribbling urine throughout the day and feeling need to urinate, but sometimes not able to do. Urethral Incontinence: Urethral Incontinence is also known Stress Incontinence. This incontinence is caused due to malposition of the sphincter unit. This type of incontinence is experienced as leakage with coughing, sneezing, laughing, lifting, exercising, or anything that increase the pressure on the bladder. The amount of leakage is generally small but it can be more severe. For the management of Incontinence there are variety of products available in market, some of them are: Absorbent product: Absorbent products such as diapers, panty liners and pads are the most commonly used incontinence product, and can be used to help manage any type of incontinence. There are companies like corium direct who are providing a huge range of Incontinence management products such as adult diapers and adult nappies. Collection Devices: Internal devices such as suprapubic catheters, as well as external devices, such as condom catheters, can be used to manage severe incontinence. Mechanical Devices: Mechanical devices like pessary, which is a rubber device that is inserted into vagina, for holding the bladder neck and uterus, can also be used without any surgical method.
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