Types of Urinary Incontinence & Their Treatment
The following are the most common types of urinary incontinence:
(i) Stress Incontinence
When the pelvic floor muscles, supporting the base of the bladder, get weak, any pressure exerted on them, by coughing, sneezing, laughing or lifting any weighty object, causes the urine to dribble out involuntarily. This is called stress incontinence.
(ii) Urge Incontinence
When a sudden urge to urinate develops and one cannot control to retain it even while rushing to reach a restroom - then, one is said to be suffering from urge incontinence. It is relevant to point out that a person has willful control over the sphincter muscle (lying at the neck of the bladder - just adjacent to urethra) that prevents urine from escaping through the urethra. If he deliberately abstains from urinating even when he receives the urge to do so, the detrusor muscle in the bladder wall will relax and permit the bladder to accommodate a little more urine before there develops another urge to urinate. When the individual chooses to urinate and allows the sphincter muscle to relax, urine flows through the urethra while the detrusor muscle in the bladder wall contracts. When this combined activity of the sphincter and detrusor muscles is adversely affected by either of the maladies such as, paraplegia, multiple sclerosis, Parkinson's disease, or even nervousness, ‘urge incontinence' develops and leads to involuntary dribbling of urine at the slightest urge to urinate.
(iii) Overflow Incontinence
When the prostrate gland (which surrounds the urethra at the outlet of the bladder) enlarges, it depresses the urethra and causes difficulties in controlling the flow of urine. If this condition is allowed to persist for long, the bladder may not be able to accumulate/retain urine beyond its capacity—which may then leak out whenever the person coughs, sneezes, or suddenly changes position. This is called overflow incontinence.
(iv) Functional Incontinence
This is not because of any defect/flaw in the urinary tract. It so happens that whenever an uncontrollable urge to urinate develops, the person fails to reach the bathroom on time either because of limited mobility or due to imbecility (mental impairment).
Remedial measures for treating urinary incontinence:
There are a number of remedial measures available to treat urinary incontinence—which includes surgery. However, before resorting to surgery, it is advisable to first try other available remedies.
(a) Wearing Aids: Disposable underwears have been developed to soak urine into a porous outer layer which neutralizes the odor, leaving the inner layer (next to the skin) relatively dry.
(b) Bladder control pads: These are capable of absorbing more liquid than the incontinence under-garments - with the result that the user can now safely reach the restroom without encountering any embarrassing situation. Famous brands are sold under the name of ‘Walgreen's' and ‘Serenity'.
(c) Dryness Aids: Developed under NASA's Research Wing, the dryness aids comprise of certain chemicals which convert any type of waste into a solid substance - thus, driving wetness away from the body. However, the choice between dryness aids and other available alternatives should be left with the user.
(d) Keggel Exercises: Pelvic floor exercises, commonly known as Keggel exercises, leave a very favorable effect on those suffering from urinary incontinence. Simply tighten the muscles as you would to stop the flow of urine - hold for a few seconds and then relax. Repeat the exercise 10 times in a series - at least twice a day. This will significantly help to control the flow of urine - and hence, curb the undesirable leakage.
(e) Self-Catheterization: Passing a thin, sterile tube through the urethra and into the bladder to draw out the accumulated urine - when the bladder itself fails to expel such accumulated urine in it - provides immediate relief from an otherwise dangerous situation. The procedure is quite safe and with a few useful tips from the Physician, one can master the art within no time.
(f) Medications: A number of medicines are available in the market for the treatment of urinary incontinence. Some of them, such as, Slifenacin (VESICARE), Oxybutynin (LYRINEL), and Tolterodine (DETRUSITOL) are worth trying.
Remember, it is only after opting for either one of the above remedial measures for urinary incontinence - that one should opt for surgery as a last resort.
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