Urinary incontinence UIalso known as involuntary urinationis any uncontrolled leakage of urine. It is a common and distressing problem, which may have a large impact on quality of life. Pelvic surgery, incontinenza urinaria BPH, childbirth, and menopause incontinenza urinaria BPH major risk factors.
Treatments include pelvic floor muscle training incontinenza urinaria BPH, bladder trainingsurgery, and electrical stimulation. Urinary incontinence can result from both urologic and non-urologic causes. Urologic causes can be classified as either incontinenza urinaria BPH or urethral dysfunction and may include detrusor overactivity, poor bladder compliance, urethral hypermobilityor intrinsic sphincter deficiency.
Non-urologic causes may include infection, medication or drugs, psychological factors, polyuriastool impactionand restricted mobility. The most common types of urinary incontinence in women are stress urinary incontinence and urge urinary incontinence. Women with both problems have mixed urinary incontinence. After menopause, estrogen production decreases and in some women urethral incontinenza urinaria BPH will demonstrate atrophy with the tissue of the urethra becoming weaker and thinner.
It is characterized by leaking of small amounts of urine with activities which increase abdominal pressure such as coughing, sneezing and lifting. Additionally, frequent exercise in high-impact activities can cause athletic incontinence to develop. Urge urinary incontinence is caused by uninhibited contractions of the detrusor muscle. It is characterized by leaking of incontinenza urinaria BPH amounts of urine in association with insufficient warning to get to the bathroom in time.
Continence and micturition involve a balance between urethral closure and detrusor muscle activity. Incontinenza urinaria BPH pressure normally exceeds bladder pressure, resulting in urine remaining in the bladder.
The proximal urethra and bladder are both within the pelvis. Intra abdominal pressure increases from coughing and sneezing are transmitted to both urethra and bladder equally, leaving the pressure differential unchanged, resulting in continence. Normal voiding is the result of changes in both of these pressure factors: urethral pressure falls and bladder pressure rises. The body stores urine — water and wastes removed by the kidneys — in the urinary bladdera balloon-like organ.
The bladder connects to the urethrathe tube through which urine leaves the body. During urinationdetrusor muscles in the wall of the bladder contract, forcing urine out of the bladder and into the urethra.
At the same time, sphincter muscles surrounding the urethra relax, letting urine pass out of the body. Incontinence will occur if the bladder muscles suddenly contract detrusor muscle or muscles surrounding the urethra suddenly relax sphincter muscles. Urination, or voiding, is a complex activity. The bladder is a balloonlike muscle that lies in the lowest part of the abdomen.
The bladder stores urine, then releases it through the urethra, the canal that carries urine to the outside of the body. Controlling this activity involves nerves, muscles, the spinal cord and the brain. The bladder is made of two types of muscles: the detrusor, a muscular sac that stores urine and squeezes to empty, and the sphincter, a circular group of muscles at the bottom or neck of the bladder that automatically stay contracted to hold the urine in and automatically relax when the detrusor contracts to let the urine into the urethra.
A third group of muscles below the bladder pelvic floor muscles can contract to keep urine back. A baby's bladder fills to a incontinenza urinaria BPH point, then automatically contracts and empties. As the child gets older, the nervous system develops. The child's brain begins to get messages from the filling bladder and begins to send messages to the bladder incontinenza urinaria BPH keep it from automatically emptying until the child decides it is the time and place to void. Failures in this control mechanism result in incontinence.
Reasons for this failure range from the simple to the complex. A careful history taking is essential especially in the pattern of voiding and urine leakage as it suggests the type of incontinence faced.
Other important points include straining and discomfort, use of drugs, recent surgery, and illness. The physical examination will focus on looking for signs of medical conditions causing incontinenza urinaria BPH, such as tumors that block the incontinenza urinaria BPH tract, stool impaction, and poor reflexes or sensations, which may be evidence of a nerve-related cause.
A test often performed is the measurement of bladder capacity and residual urine for evidence of poorly functioning bladder muscles. Patients are often asked to keep a diary for a day or more, up to a week, to record the pattern of voiding, noting times and the amounts of urine produced.
Research projects that assess the efficacy of anti-incontinence therapies often quantify the extent of urinary incontinence.
The methods include the 1-h pad test, measuring leakage volume; using a voiding incontinenza urinaria BPH, counting the incontinenza urinaria BPH of incontinence episodes leakage episodes per day; and assessing of the strength of pelvic floor muscles, measuring the maximum vaginal squeeze pressure.
Yearly screening is recommended for women by the Women's Preventive Services Initiative. Screening questions should inquire about what symptoms they have experienced, how severe the symptoms are, and if the symptoms incontinenza urinaria BPH their daily lives.
Treatment options range from conservative treatment, behavior management, bladder retraining,  pelvic floor therapycollecting devices for menfixer-occluder devices for incontinence in menmedications and surgery. Behavioral therapy involves the use of both suppressive techniques distraction, relaxation and learning to avoid foods that incontinenza urinaria BPH worsen urinary incontinence. This may involve avoiding or limiting consumption of caffeine and alcohol. Behavioral therapy is not curative for urinary incontinence, but it can improve a person's quality of life.
Behavioral therapy has benefits as both a monotherapy incontinenza urinaria BPH as an adjunct to medications for symptom reduction. Avoiding heavy lifting and preventing constipation may help with uncontrollable urine leakage. Stopping smoking is also recommended as it is associated with improvements in urinary incontinence in men and women.
Exercising the muscles of the pelvis such as with Kegel exercises are a first line treatment for women with stress incontinence. Small vaginal cones of increasing weight may be used to help with exercise. Biofeedback uses measuring devices to help the patient become aware of his or her body's functioning.
By using electronic devices or diaries to track when the bladder and urethral muscles contract, the patient can gain control over these muscles. Biofeedback can be used with pelvic muscle exercises and electrical stimulation to relieve stress and urge incontinence. Time voiding while urinating and bladder training are techniques that use incontinenza urinaria BPH.
In time voiding, the patient fills in a chart of voiding and leaking. From the patterns that appear in the chart, the patient can plan to empty his or her bladder before he or she would otherwise leak.
Biofeedback and muscle conditioning, known as bladder training, can alter the bladder's schedule for storing and emptying urine. These techniques are effective for urge and overflow incontinence . A randomized controlled trial found no benefit of adding biofeedback to pelvic floor muscle exercise in stress urinary incontinencebut observing improvements in both groups. Preoperative pelvic floor muscle training PFMT in men undergoing radical prostatectomy was not effective in reducing urinary incontinence.
Alternative exercises have been studied for stress urinary incontinence in women. Individuals who continue to experience urinary incontinence need to find a management solution that matches their individual situation. The use of mechanical devices has not been well studied in women, as of A number of medications exist to treat urinary incontinence including: fesoterodine incontinenza urinaria BPH, tolterodine and oxybutynin.
Medications are not recommended for those with stress incontinence and are only recommended in those with urge incontinence who do not improve with bladder training. Surgery may be used to help stress incontinenza urinaria BPH overflow incontinence. Due to the risk of debilitating painful side effects such as vaginal erosion,  and in transvaginal mesh implants were classified as a high risk device by the US Food and Drug Incontinenza urinaria BPH.
In those with problems following prostate surgery there is little evidence regarding the use of surgery. Urethral injectable materials are of unclear benefit. Bladder control problems have been found to be associated with higher incidence of many other health problems such as obesity and diabetes. Difficulty with bladder control results in higher rates of depression and limited activity incontinenza urinaria BPH.
Incontinence is expensive both to individuals in incontinenza urinaria BPH form of bladder control products and to the health care system and nursing home industry. Injury related to incontinence is a leading cause of admission to assisted living and nursing care facilities. Incontinence happens less often after age 5: About 10 percent of 5-year-olds, 5 percent of year-olds, and 1 percent of year-olds experience episodes of incontinence.
It is twice as common in girls as in boys. Bladder symptoms affect women of all ages. However, bladder problems are most prevalent among older women. Men tend to experience incontinence less often than women, and the structure of the male urinary tract accounts for this difference.
It is common with prostate cancer treatments. Both women and men can become incontinenza urinaria BPH from neurologic injury, congenital defectsstrokes incontinenza urinaria BPH, multiple sclerosisand physical problems associated with aging.
While urinary incontinence affects older men more often than younger men, the onset of incontinence can happen at any age. Estimates in the mids suggested that 17 percent of men over age 60, an estimatedmen, experienced urinary incontinence, with this percentage increasing with age.
The management of urinary incontinence with pads is mentioned in the earliest medical book incontinenza urinaria BPH, the Ebers Papyrus BC.
Incontinence incontinenza urinaria BPH historically been a taboo subject in Western culture. However, this situation changed some when Kimberly-Clark aggressively marketed adult diapers in incontinenza urinaria BPH s with actor June Allyson as spokeswoman. Allyson was initially reticent to participate, but her incontinenza urinaria BPH, who had incontinence, convinced her that it was her duty in light of her successful career.
The product proved a success. From Wikipedia, incontinenza urinaria BPH free encyclopedia. Urinary incontinence Other names Involuntary urination Specialty Urologygynecology Urinary incontinence UIincontinenza urinaria BPH known as involuntary urinationis any uncontrolled leakage of urine. Main article: Enuresis. Maryland Heights, Mo: Mosby. Taber's cyclopedic medical dictionary.
Philadelphia: F. July 16, Retrieved NPS MedicineWise.