Urinary incontinence is a symptom and indicates the uncontrollable leakage of urine.

This can produce a lot of discomfort to patients having this disorder or symptom.

Elderly women are more susceptible to it than men.

With a longer life span many elderly patients can be observed being brought to the family doctor clinic wearing adult diapers.

Elderly patients are likely to believe that the only way to prevent embarrassment is to wear absorbent menses pads or padded undergarments like adult diapers.

However the skin wetness may result in rashes, sores, or infections.

Most people with urinary incontinence are women mainly because childbirth weakens the pelvic floor muscles.

Old age in turn such as the menopause produce both weakness and other age related disorders which can affect the period of time the patient can wait once the patient feels the urge to go

Alcoholism and an enlarged prostate can both produce it as well, but childbirth related muscle weakness remains the most frequent cause.

Causes:

With aging, the bladders are not capable of holding as much urine and the sphincter muscles may weaken reducing the body’s ability to stop the urination.

In women the reduction in estrogen after menopause causes the lining of the urethra to be thinner so that it might not close properly permitting urine to leak out.

Childbearing can also raise the danger of forming urinary incontinence.

With age or after vaginal delivery, the pelvic muscles are never as strong as the way they were before birth, particularly after multiple deliveries.

Everyone tend more likely to become incontinent with age because of both the deterioration of the organs and brain

Women have the greater disorder because of childbirth, the menopause and also having a shorter outlet

Other causes:

Diabetes, neurological diseases, and nerve injury

In men and women, urinary incontinence can be due to neurological disorders such as multiple sclerosis, spinal cord injury, and Parkinson’s disease.

Pelvic surgery or prostate surgery

Enlarged prostate in men

Pelvic organ such as uterus prolapse in women

Urinary Incontinence is a medical symptom which may be temporary or permanent

Urinary incontinence may be categorized into 4 main types:

Stress

Urge

Overflow

Functional

Mixed

A full history and physical examination will be able to help the doctor to diagnose urinary incontinence, type and possible causes of the incontinence.

Urinalysis

Post-void Residual Measurement

Ultrasound

Urodynamic Testing

Pad tests

Void diary

Cystoscopy

Treatment:

A. Lifestyle changes.

Scheduled Toileting

Double Voiding

Bladder Training

Reducing Fluid

Kegel exercises

Vaginal cone therapy

Biofeedback

Electrical stimulation

B. Treating the cause of the incontinence

Medicines

antidepressant

anticholinergic

Oxybutynin

Nighttime voiding and incontinence

Desmopressin (DDAVP)

Pessaries

C. Surgery

Removal of Enlarged Prostate

Bladder repositioning

Bladder neck suspension

Periurethral bulking therapy

Mid-urethral slings

Artificial urinary sphincter

Retropubic suspension

The transobturator male sling

Transobturator vaginal tape

Sacral nerve modulation

Injection of neurotoxins such as botulinum toxin

D. Catheterization

Indwelling urethral catheters

Suprapubic catheter

Intermittent Catheterization

Medicated and silver-coated catheters

Other Methods:

Absorbent Pads

Intra-vesical pharmacotherapy

Accupuncture

New Methods:

Potassium channel openers

Prostaglandins

Estrogens

Urethral injection of a combined patient-derived adipose stem cells (ASCs) and collagen

TABLE OF CONTENT

Introduction

Chapter 1 Incontinence of Urine

Chapter 2 Causes

Chapter 3 Symptoms

Chapter 4 Diagnosis

Chapter 5 Treatment

Chapter 6 Prognosis

Chapter 7 Nocturnal Enuresis

Chapter 8 Cystitis

Epilogue