Urinary incontinence is the involuntary loss of urine.  There are three types of incontinence:

  1. Stress incontinence – when urine leaks if you move, sneeze, cough or laugh[1]
  2. Urgency incontinence – when you have the urge to go to the bathroom and urine leaks at the same time. This may be part of another condition known as Overactive Bladder.[2]
  3. Overflow incontinence – when you cannot empty your bladder[3]

Some woman will experience stress and urgency incontinence which is referred to as mixed incontinence. [4]

Filling and emptying of the bladder is a complex interplay of nerve signals, kidney function, and muscle activity.  As part of normal bladder function, the kidneys produce urine, which travels to the bladder.  One of the major muscles of the bladder is the detrusor.  As part of the normal process of urination, the detrusor muscle will contract in response to filling of the bladder with urine.  The contraction and relaxation of the detrusor muscle is regulated by the nervous system.  Approximately 300mL of urine in the bladder signals the nerves to trigger the bladder muscles to coordinate urination.  Urine is voided by draining from the bottom of the bladder through a short tube called the urethra.  Voluntary control of the sphincter muscles at the opening of the bladder can hold the urine in the bladder for longer.  Up to 600mL of urine can be contained in a normal adult bladder.  Involuntary loss of urine is referred to as incontinence. [5]

Causes of Urinary Incontinence

Urinary incontinence is not a disease but a symptom of everyday activities or a medical condition. Persistent incontinence can be caused by: [6]

  • Changes with age
  • Being overweight
  • Weak pelvic floor muscles following a vaginal birth
  • Hysterectomy
  • Menopause
  • Enlarge prostate
  • Prostate Cancer
  • Neurological disorders
  • Genetics
  • Specific medications

Treatment for Urinary Incontinence

Unfortunately there are very few effective treatments for incontinence. Anticholinergic medications are effective for treating urgency incontinence but these medications will not improve stress incontinence. Men are prescribed the same medications used to treat an enlarged prostate for the treatment of overflow incontinence. These treatments include, tamsulosin, alfuzosin, finasteride and dutasteride.

Stress incontinence may be treated by surgery.

Urethral Bulking Agents: a semi-solid material can be injected into the urethra through a cystoscope. This material helps the urethral sphincter close.

Slings: various types of slings for men and woman have been used to compress the urethra, prevent leakage or move the urethra into a different position.

Urgency incontinence may also be treated with surgery or procedures.

Never Stimulation: a nerve in the ankle is stimulated with a needle and a machine for 30 minutes a day. Some people have good results with this technique but it does require long-term use of the machine.

Botox: the ability for the bladder muscles to contract is reduced temporarily.

Clinical research trials are underway to find and improve treatments for incontinence.








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