Urinary incontinence is the involuntary leakage of urine.It is a common and often embarrasing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that’s so sudden and strong you don’t get to a toilet in time. It means a person urinates when they donot want to. Control over the urinary sphincter is either lost or weakened. Urinary incontinence is more common among women then men.Though it occurs more often as people get older, urinary incontinence is not an inevitable consequence of aging.
Urinary incontinence is divided into following general types. You can potentially experience more then one type at the same time.
• Stress incontinence –
It is trigerred by certain types of physical activity.For example, you might lose control of your bladder when you are-
Such activities put stress on the sphincter muscle that holds urine in your bladder.The added stress can cause the muscle to release urine.
• Urge incontinence –
Urge incontinence occurs when you lose control of your bladder after experiencing a sudden and strong urge to urinate. Once that urge hits, you may not be able to make it to the bathroom in.
• Overflow incontinence –
Overflow incontinence can occur if you don’t completely empty your bladder when you urinate. Later, some of the remaining urine may leak from your bladder. This type of incontinence is sometimes called dribbling.
• Functional incontinence –
Urine escapes because a person cannot reach the bathroom in time, possibly due to a mobility issue such as arthritis.
• Mixed incontinence –
A combination of above mentioned types makes your bladder to leak.
What happens normally?
The brain and the bladder control urinary function. The bladder stores urine until you are ready to empty it. The muscles in the lower part of the pelvis hold the bladder in place. Normally, the smooth muscle of the bladder is relaxed. This holds the urine in the bladder. The neck (end) of the bladder is closed. The sphincter muscles are closed around the urethra. The urethra is the tube that carries urine out of the body.When the sphincter muscles keep the urethra closed, urine doesn’t leak.
Once you are ready to urinate, the brain sends a signal to the bladder. Then the bladder muscles contract. This forces the urine out through the urethra, the tube that carries urine from the body.The sphincters open up when the bladder contracts.
• Leaking urine during everyday activities, such as lifting, bending, coughing or exercising
• Feeling a sudden, strong urge to urinate right away
• Leaking urine without any warning or urge
• Being unable to reach a toilet in time
• Wetting your bed during sleep
Urinary incontinence can be caused by everyday habits, underlying medical conditions or physical problems.
Temporary urinary incontinence-
Certain drinks, foods and medications may act as diuretics- stimulating your bladder and increasing your volume of urine. They include-
• Carbonated drinks and sparkling water
• Artificial sweeteners
• Chilli peppers
• foods that are high in spice, sugar or acid, especially citrus fruits
• heart and blood pressure medications, sedatives and muscle relaxants
• large doses of vitamin C
Urinary incontinence may also be caused by an easily treatable medical condition, such as –
• Urinary tract infection.
Infections can irritate your bladder, causing you to have strong urges to urinate and sometimes incontinence.
The rectum is located near the bladder and shares many of the same nerves.Hard, compacted stool in your rectum causes these nerves to be overactive and increase urinary frequency.
Persistent urinary incontinence –
Urinary incontinence can also be a persistent condition caused by underlying physical problems or changes , including –
• Pregnancy –
Hormonal changes and the increased weight of the foetus can lead to stress incontinence.
• Childbirth –
Vaginal delivery can weaken muscles needed for bladder control and damage bladder nerves and supportive tissue, leading to a dropped (prolapsed) pelvic floor.With prolapse, the bladder, uterus, rectum or small intestine can get pushed down from the usual position and protrude into the vagina. Such protrusions may be associated with incontinence.
• Changes with age-
Aging of the bladder muscle can decrease the bladder’s capacity to store urine. Also, involuntary bladder contractions become more frequent as you get older.
After menopause,women produce less estrogen, a hormone that helps keep the lining of the bladder and urethra healthy. Deterioration of these tissues can aggravate in continence.
• Enlarged prostate –
Especially in older men, incontinencee often stems from enlargement of the prostate gland, a condition known as benign prostatic hyperplasia.
• Prostate cancer-
In men, stress incontinence or urge incontinence can be associated with untreated prostate cancer. But more often, incontinencee is a side effect of treatments for prostate cancer.
A tumor anywhere along your urinary tract can block the normal flow of urine, leading to overflow incontinence.Urinary stones – hard, stone like masses that form in the bladder – sometimes cause urine leakage.
• Neurological disorders-
Multiple sclerosis, Parkinson’s disease, a stroke, a brain tumor or a spinal injury can interfere with nerve signals involved in bladder control, causing urinary incontinence.
Risk factors –
• Gender – females are more prone than males.
• Age- Older age increase the risk of urinary incontinence.
• Being overweight
• Family history
• Some diseases- Such as neurological disease or diabetes
• Skin problems-
A person with urinary incontinence is more likely to have skin sores, rashes and infections because the skin is wet or damp most of the time. This is bad for wound healing and also promotes fungal infections.
• Urinary tract infections –
Long term use of a urinary catheter significantly increases the risk of infection.
• Prolapse –
Part of the vagina, bladder and sometimes the urethra can fall into the entrance of the vagina. This is usually caused by weakened pelvic floor muscles.
• Social Stigma-
Embarrassment can cause people to withdraw socially and this can lead to depression.
It is important to determine the type of urinary incontinence that you have.This information will guide treatment decisions. After a thorough history and physical exam you may be asked to do a simple maneuver that can demonstrate incontinence, such as coughing.
After that, your doctor will likely recommend-
• Urinalysis for infections or other abnormalities
• Bladder diary to record how much you drink,when you urinate, the amount of urine you produce and the number of incontinence episodes.
• Postvoidal residual measurement. You are asked to urinate into a container that measures urine output.Then You doctor checks the amount of leftover urine in your bladder by using a catheter or ultrasound test.
Treatment for urinary incontinence depends on the type of incontinence, its severity and the underlying cause.
Behavioral techniques –
• Bladder training, to delay urination after you get the age to go. You may start by trying to hold off for 10 minutes every time you feel an urge to urinate.The goal into lengthen the time between trips to the toilet.
• Double voiding, to help you learn to empty your bladder more completely to avoid overflow incontinence. Double voiding means urinating, then waiting a few minutes and trying again.
• Scheduled toilet trips, to urinate every two to four hours rather than waiting for the need to go.
• Fluid and diet management, to regain control of your bladder. You may need to cutback on oravoid alcohol, caffeine or acidic foods
Pelvic floor muscle exercises –
To do peIvic floor muscle exercises, imagine that you are trying to stop your urine flow . Then –
• Tighten (contract) the muscles you would use to stop urinating and hold for 5 seconds and then relax for 5 seconds.
• Workup to holding the contractions for 10 seconds at a time.
• Aim for at least three sets of 10 repetitions each day.
• Anticholinergics such as oxybutynin (Ditropan XL), tolfero dive (Detrol)
• Mirabegron( Myrbetriq)
• Alpha blockers such as tamsulosin (Flomax), doxazosin (Cordura)
• Topical estrogen in theform of a vaginal cream, ring or patch may help tone and rejuvenate tissues in the urethra and vaginal areas
Medical devices –
• Urethral insert
• Bulking material injections
• Onabotulinum A (Botox)
• Nerve stimulators
• Sling procedures
• Bladder neck suspension
• Prolapse surgery
• Artificial urinary sphincter
Absorbent pads & Catheters –
• Pads & protective garments
From the Ayurvedic perspective, Urinary incontinence is a vata predominant disorder in which vitiated action of Apana Vayu is clearly visible Among all types of urinary incontinence, Uttar Basti is a very effective and safe ayurvedic panchkarma method which strikes the root cause of this problem.
Beneficial Herbs –
• Bala Oil –
• Sahchar Oil –
• Jamun seed Powder-
• Walnuts –
Effective Medications –
• Chandraprabha Vati
• Vishatinduka Vati
• Dhanwantaram Kashayam
• Aswagandha Churna
• Surya Namaskara –
• Ushtrasana –
• Utkatasana –
• Mood bandha –
• Pavan muktasana
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