Incontinence in literal means involuntary leakage of urine. The incontinence may be urge incontinence or leakage following inability to postpone urination. It may be stress Incontinence which is leakage on cough or stress.
Million of men and women suffer from incontinence in silence thinking that it is an inevitable outcome after multiple child births or ageing.
The men also have prostate which can equally be responsible for the incontinence.
Types of Incontinence
Stress Urinary Incontinence ( SUI)
This type of incontinence occurs when the control valve of the bladder outlet is damaged or weakened because of multiple causes. This may include pelvic prolapse, multiple child births, previous surgery usually prostatectomies in men. This leads to leakage of urine on any involuntary abdominal stress for example coughing or sneezing or straining.
This type of leakage occurs when the incontinence happens when one is unable to postpone urination. This occurs due to over activity of bladder or uninhibition of bladder contractility. This may be de novo or on its own or may be the result of any previous surgery or procedure.
When both stress and urgency incontinence occur together.
This occurs when leakage occurs after inability to pass out urine completely, leading to spillover of urine outside leading to wetting of clothes.
The patients are often not forthcoming due to embarrassment and taking it as normal part of ageing. The treatment is usually directed by the cause of incontinence and mostly starts from the basic therapy like medical treatment with drugs.
Includes Bladder Diary which is basically a record of the fluid that one consumes vis a vis the urine collection charted over couple of days which is an indirect measure of urine output, toilet habits and hydration of the patient.
Along with these basic tests are included Ultrasonography of the abdomen which test the kidneys and bladder and the post void residual urine.
General Urine tests include Urine routine and Culture.
Uroflowetry : A measure of how fast or slow the speed of exiting urine is, which when scaled against population database provides the appropriate measure of obstruction.
Urodynamics : It is an elaborate measure of pressure of the bladder measured against the flow and symptoms of the patient. This is never a first line treatment and is indicated only in rare circumstances when the treatment has failed or rare causes are suspected as in Neurological causes.
Treatment is started with correction of lifestyle if indicated to drugs and last resort any corrective surgery.
This may include Prostatectomy in Male.