Urinary Incontinence-
A common condition with many causes which should be treated accordingly

Urinary incontinence is a fairly common problem. There are several causes for the problem, so the treatments can vary. In order to determine which treatment is the safest and best, it is imperative that the cause be sought and that shotgun or bandaid treatment approaches are avoided.

Classification of incontinence are devided into general types, though there is often a combination of types that are at the root of the problem.

Stress incontince is usually due to weakness of the support of the bladder
which causes it to drop. When any form of pressure is placed on the bladder, urine is forced out (usually in relatively small amounts. Leaking on standing, coughing, laughing or straining are usual insitigators of this type of urine loss. A varient of this problem is caused by the inability of the urethra (urinary tube) to produce resistance to pressure caused by problems with the urethra itself, usually secondary to surgery, or scarring.

Overflow incontinence is the loss of urine, because the bladder does not empty (for example, with BPH obstruction). The bladder fills until its pressure exceeds the urethra's ability to contain it and urine leaks out.

Urgency incontinence is caused by a neurologic problem, in which the normal urge to void which can be voluntarily suppressed, is replaced by an extreme urge with an immediate loss of urine. Sometimes there is a slight delay, but the patient is not able to get to the bathroom on time and leaks

Other forms of incontinence include the inability of a physically handicapped individual to get to the bathroom, commode or use a urinal, so they simply urinate. Dementia, or advanced age can be associated with the patient's failure to recognize the signal that they have to void. Neurologic diseases of the bladder that affect the sensation of filling, such that the patient is unaware that they have to void is another type of neurologic incontinence.

Finally, Polyurea, which is most commonly associated with Diabetes Mellitus or Diabetes Insipidus, and is defined as a daily output of greater than 2500mL of urine per day, can cause the bladder to fill rapidly and might lead to incontinence, if the bathroom cannot be reached in time

Of course, there can be combination of causes at work in the individual, and these have to be sorted out and, possibly treated separately to allow the individual to regain control.

New approaches are available that include new drugs and other non-drug treatments that can be tailored to the individual patient's condition and need.

For more information, you may call the office at (800)886-6690 ext 11

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