The involuntary or accidental loss of urine is referred to as "incontinence". It can affect people of all ages for a variety of reasons.
Urge incontinence is now commonly referred to as "overactive bladder" and is caused by the bladder muscle contracting and expelling urine when it shouldn't. Many medical conditions can result in urge incontinence including stroke, Parkinson's disease, multiple sclerosis and prostate enlargement. However, "overactive bladder" can also occur without any of these more serious problems. Urge incontinence is easily treated with any of a variety of medications. The newer oral ones include Ditropan XL, Detrol LA, Vesicare, Enablex, and Sanctura. Oxytrol is a patch worn on the skin for overactive bladder.
Stress incontinence is usually caused by the bladder and urethra not being in the normal position. Obesity, smoking, prior surgery and multiple childbirths may all contribute to this condition. In select patients, a simple program of Kegel exercises may reduce or relieve stress incontinence provided the exercises are done regularly and faithfully for the necessary period of time (usually 6-8 weeks).
Some cases of incontinence must be corrected with surgery. Modern surgical techniques for incontinence can be performed as an outpatient using a small vaginal incision. Through this incision, a sling is positioned about the urethral and bladder base to restore the normal closing action of the bladder neck and prevent incontinence. The success rate approaches 95 percent.
One lesser known type of incontinence is overflow incontinence. Overflow incontinence is caused by a bladder that is full to capacity and cannot empty. Any further urine production from the kidneys "overflows" out of the body. Overflow incontinence can lead to infection or kidney failure. Patients with overflow incontinence will often have a long history of diabetes, severe prostate obstruction or recent major surgery (hip replacement, hernia repair, etc.). Patients with overflow incontinence should have a drainage catheter placed and be seen by a urologist in short order.
Copyright (C) 2019 Steven A. Johnson, M.D., P.A.
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