Incontinence is the involuntary discharge of urine or faeces due to a lack of control by the bladder (Urinary Incontinence) or bowel (Faecal Incontinence).
The excretory system of urine is called the urinary tract and comprises the kidneys, the ureters, the bladder and the urethra. Urine is filtered by the kidneys and transported via two tubes (ureters) into the bladder. Several layers of muscle form the wall of the bladder; the thickest is called the detrusor muscle. At the junction of the bladder and the urethra is the sphincter muscle whose function is to control the flow of urine through the urethra.
A healthy bladder is capable of expanding to accommodate 300-500 ml of fluid. At 200ml. we get the first urge to urinate. When this occurs, the detrusor muscle contracts, the sphincter muscle relaxes and urine is forced out through the urethra. Once finished, the process is reversed: the bladder relaxes and the sphincter contracts, stopping the flow of urine.
Your ability to control urination requires a normal anatomy, a normally functioning nervous system and being able to determine and respond to the warning signs of impending urination. Urinary incontinence occurs when you are unable to control the flow, causing leakage or in severe cases an inability to retain urine.
Types, Causes and Treatment
There are five recognized types of urinary incontinence: Urge, Stress, Overflow, Functional and Mixed Incontinence.
- Urge Incontinence – Described as a sudden and uncontrollable urge to urinate and unable to get to the toilet in time to avoid loss of a substantial amount of urine. It can also manifest itself by an intense urge to urinate when there is only a small amount of urine in the bladder, resulting in the person straining to urinate.
The leading causes of urge incontinence have been identified as neurological disorders, urinary tract infections and changes in the bladder leading to its inability to contract effectively.
Effective treatment includes pelvic muscle exercises, bladder retraining, biofeedback and drugs in persistent cases.
- Stress Incontinence -- The most common type of this affliction. This is an involuntary loss of urine when you sneeze, cough, laugh, jog or perform any other activity which may increase pressure on the bladder.
This occurs due to weakened support for the pelvic muscles and/or weakness in the sphincter muscle.
The treatment for urge incontinence is the same as that of stress, however, surgery may also be recommended.
- Mixed Incontinence – This is the diagnosis for persons presenting the symptoms of both urge and stress incontinence.
A widely held belief is that people with stress incontinence frequently empty their bladders prematurely, conditioning the bladder to function at a low capacity.
Treatment is focused on the primary cause, employing the previously mentioned methods.
- Overflow Incontinence – In this situation, there is frequent leakage without the person having any prior urge to urinate. The urine stream is usually weak.
This can be due to an obstruction of the bladder, causing it to become too full and eventually leaking. Other probable causes are neurological disorders, medication, constipation, another medical condition (enlarged prostate) and post-surgery side effects.
This is usually treated through a change in diet, drugs or surgery.
- Functional Incontinence -- This is not associated with any problem in the person’s urinary tract but due to a pre-existing condition such as a physical or cognitive impediment, restricted mobility, nervous system disorders, or an inability to communicate. This affliction is very prevalent among people needing long-term care.
There are no treatments in this situation but there’s an assortment of incontinent supplies such as mattress covers, pads, reusable underwear (panties and briefs) and adult diapers to be employed in this situation.
The Silent Affliction
Let there be no misconceptions, incontinence is not an affliction of the aged. In fact, adults of any age can develop this ailment with women being more at risk than men. This being due to anatomical differences and the changes brought on by pregnancy and childbirth. The risks increase with age, however, because as the body ages, muscles weaken making urine retention more difficult. Many people with incontinence suffer in silence. Excretion (Incontinence) has always been an embarrassing topic, instead of seeking help most people try to manage the situation by themselves even keeping it from their doctor. This can often lead to the development of additional problems including low self-esteem, social withdrawal, isolation, and depression. This need not be so; in most cases, incontinence can be treated. If you are suffering in silence or think you may have a problem, do not hesitate to consult your doctor.
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