Urinary incontinence
Urinary incontinence refers to involuntary loss of urine, causing embarrassment and inconvenience for the patient. Causes are numerous and can be grouped into some well recognized patterns. Prostatic hyperplasia is a common cause in men while in women child birth or gynecologic procedures often lead to urinary incontinence.
- Stress Incontinence: The sphincter fails to hold urine when intra-abdominal pressure rises as in coughing or laughing. This is more common in elderly obese women. Pelvic floor weakness due to old age, child birth or after menopause is a common underlying cause.
- Urge incontinence: An urge to urinate is quickly followed by uncontrollable emptying of bladder. Motor urgency refers to incontinence due to overactive detrusor muscle. Sensory urgency refers to a hypersensitive bladder due to infection or stone.
- Overflow incontinence: This occurs in men with prostatic hyperplasia or in patients with atonic bladder. A chronically over-distended bladder (due to distal obstruction or loss of tone) overflows, especially at night when sphincter is relatively relaxed.
- Continuous incontinence: This is due to anatomic defects like birth anomalies (ectopic ureteric opening) or vesicovaginal fistula (after gynecologic surgery).
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