Urinary Incontinence

Urinary incontinence is a much more common and often embarrassing problem than most people realize. Urinary incontinence is the involuntary leakage of urine which is more common among women than men. It is common in approximately 30 percent of females who are aged between 30-60.

Symptoms

The severity ranges from occasionally leaking urine on coughing or sneezing to having a sudden urge to urinate and a person does not reach a toilet in time.

Types of urinary incontinence include:

1. Stress incontinence : In this case Urine leaks when pressure is exerted on the bladder due to any of the following actions:
   • Lifting something heavy
   • Laughing
   • A sudden cough
   • Sneezing
   • Exercise
2. Urge incontinence : Urge incontinence also is known as Overactive Bladder. One has a sudden, intense urge to urinate followed by an involuntary loss of urine as a result of :
   • Cystitis – inflammation of the lining of the bladder
   • CNS (central nervous system) problems – examples are multiple sclerosis, stroke, and Parkinson’s disease
   • An enlarged prostate – the bladder may drop, and the urethra could become irritated
   • Infection
   • The sound of running water (for some people)
3. Overflow incontinence. This type is common in Males having prostate problems or a blocked urethra. In this bladder is not able to hold the urine one’s body produces.
4. 4. Gross total incontinence This is marked by the complete absence of control over the bladder. That mean bladder cannot store any urine at all.

Diagnosis of Urinary incontinence

• Urinalysis.
• Cystogram
• Cystoscopy
• Pelvic Ultrasound
• Urodynamic Study

TREATMENT OPTIONS FOR URINARY INCONTINENCE IN FEMALES :

Treatment for urinary incontinence depends on several factors, such as the type of incontinence, its severity, underlying cause, the patient’s age, general health, and their mental state. Treatment options include the following:

1. Behavioral techniques
2. Pelvic floor muscle exercises
3. Medical devices : Certain devices are designed to treat females with incontinence. These include:
   • Urethral insert
   • Pessary
   • Botox
   • Sacral nerve stimulators

SURGERY IN URINARY INCONTINENCE

If other treatment options are not effective then Surgery is the ultimate option to get rid of Urinary Incontinence. Few effective surgical procedures include:

1. Sling procedures :A sling is a synthetic material(mesh) which is placed around the neck of the bladder to create a pelvic sling around the Urethra to support it hence prevents accidental urine leakage.
   • Transobturator Tape procedure (TOT)
   • Retropubic Tape procedure or Tension-free Vaginal Tape procedure (TVT)

   Slings help hold the Urethra up in the correct position and help reduce the leaking of urine associated with stress incontinence.

2. Bladder neck suspension/ Colposuspension :In this, the neck of the bladder is lifted laparoscopically.

TREATMENT OPTIONS FOR URINARY INCONTINENCE IN MALES:

1. Male sling procedures: Sling procedures for men are relatively new but initial studies have shown a good success rate. The sling supports the damaged sphincter valve.
2. Artificial urinary sphincter: Artificial urinary sphincter is a fluid filled device which is implanted under the urethra. Artificial sphincters are particularly helpful for men whose incontinence is associated with the treatment of prostate cancer or an enlarged prostate gland.

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