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sign and symptoms of urinary incontinence

sign and symptoms of urinary incontinence

Date:   6/10/2022 4:21:53 AM   ( 26 mon ) ... viewed 489 times

Urinary incontinence refers to the symptoms of an involuntary losing (leakage) of urine. It is a condition that affects both genders but finds more prevalence in women.

The cause behind incontinence in males has been linked to various conditions like prostate enlargement or injuries to the continence system when undergoing surgery or radiotherapy to treat prostate cancer. In contrast, incontinence in women has often been linked to a dysfunction in the pelvic floor or bladder muscles, with the problem typically arising during pregnancy, childbirth, or menopause. 

Over the years, studies have distinguished urinary incontinence into two primary types: urgency incontinence and stress incontinence. Based on the International Urogynecological Association (IUGA) and the International Continence Society (ICS), the standard definition of stress incontinence refers to the sensation of leakage from the urine that is associated with sneezing or coughing and physical activity. In contrast, urgency incontinence is urine leakage associated with an intense urge to void, which is hard to resist[1]. These two types are so prevalent that they frequently coexist with various symptoms, referred to as mixed incontinence. The majority of women suffering from urgency incontinence are also diagnosed with excessive bladder symptoms, in which urgency incontinence is one possibility of the components.[2]

THE DIFFERENT TYPES OF URINARY INCONTINENCE ARE:

1.     Urge incontinence: It is the need to go to the bathroom immediately. In most cases, it happens too fast for the person to reach a toilet on time, resulting in urine leakage. Urge incontinence is often the result of a disorder known as the overactive bladder (OAB). A person can be suffering from OAB for many reasons, including weak pelvic muscles and nerves, nerve damage, infection, and low estrogen levels following menopausal or having a higher body weight. Certain beverages and medications such as caffeine and alcohol can also trigger OAB.

2.     Incontinence due to stress: Leakage of urine while doing activities is usually stress incontinence. In this kind of incontinence, the pelvic floor muscles have become weak and can no longer support the pelvic organs as they ought to. This muscle weakness means the person is more likely to leak urine as one moves around accidentally. Many people experience leakage issues when they laugh out loudly, cough, sneeze, jump, run or lift objects. All of these actions put pressure on the bladder. One is more likely to leak urine if they do not have strong pelvic muscles and a strong pelvic floor. Women who give birth are at a greater chance of developing stress incontinence. Men who have undergone prostate surgery can be prone to developing stress incontinence.

3.     Incontinence overflow: If the bladder does not empty every time one goes to the bathroom, they could be suffering from overflow incontinence. Overflow-incontinence sufferers do not fully empty their bladders, which puts them at risk of spills. In most cases, this causes tiny amounts of urine to spill out over time (similar to a leaky balloon, deflating over time) instead of a complete splash out (similar to pricking the balloon with a pin.)

4.     Mixed Incontinence: Mixed incontinence is a mix of several issues that cause leakage issues. If one suffers from mixed incontinence, they could also suffer from stress-related incontinence and an overactive bladder. It is essential to keep an eye on what the person is doing when experiencing leakage issues in case of mixed incontinence. Recognizing the triggers for mixed incontinence is the most effective way to deal with it.

THE SYMPTOMS AND RISK FACTORS:

Thorough patient history should include the beginning, duration, and frequency of urinary incontinence and the resulting LUTS and voiding symptoms in recognizing that the alleged symptoms usually relate to the usual bladder functions and their expectations. Other risk factors or conditions that can exacerbate urinary incontinence should also be assessed, including: age, obstetric history (parity and mode of delivery), gynecological status (the presence of pelvic organ prolapse, defecatory dysfunction or anal incontinence, sexual dysfunction, and urogenital syndrome of menopause), medical status (the presence of a UTI, dementia, delirium, diabetes mellitus or diabetes insipidus, cardiorespiratory disorders, chronic cough, obesity, and obstructive sleep apnoea) and pharmacological status (the use of hormonal replacement therapy, adrenergic agonists and antagonists, calcium channel blockers, diuretics, lithium therapies, opioid analgesics, anticholinergics, and angiotensin-converting enzyme inhibitors.[3] 

Patients suffering from moderate cognitive impairments are about 30% more likely to experience urinary incontinence.[4] Additionally, lifestyle and functional factors, like the level of smoking, mobility, and the frequency of lifting heavy, must be considered in the assessment. Certain patients may present a history of symptoms that suggest other urinary tract disorders that can also cause urinary incontinence; however, these patients require specialist referral.[5]

Incontinence symptoms are persistent, have a significant impact on the quality of life, and result in high costs for individuals and society[6]. Incontinence of all kinds is witnessed more with weight gain and age. Therefore, the health burden of these ailments is likely to rise with the present demographic trends. The impact on people and the populations affected by these conditions is substantial compared to the attention they get in the media or the level at which research is conducted on incontinence.

WHAT ARE THE SIGNS OF INCONTINENCE?

The primary symptom of urinary incontinence is urinary leakage, which may be a regular drip of urine or a few instances of leakage. If one suffers from incontinence, there could be large or even small amounts of leakage urine. It is possible to experience leakage for many reasons, primarily based on the kind of incontinence. Reasons behind urine leak can be:

·      Exercise.

·      Cough.

·      Have a good laugh.

·      Sneeze.

PRODUCTS FOR WOMEN:

  • Pessaries: Disposable devices placed into the vagina to help support the bladder and pressure the urethra to prevent urine leakage. Pessaries come in various dimensions and shapes, including rings, cubes, or dishes.
  • Urethral insert: It is a balloon made of soft plastic that is placed inside the urethra. It prevents urine from draining out. The insert must be removed in case of voluntary urination. Some women utilize inserts just a portion of the time, for example, when they exercise. Some use them all day. To avoid the spread of germs, apply a new disposable insert that is sterile each time.
  • Disposable vaginal implant: It is a device placed into the vagina, similar to a tampon. It applies pressure to the urethra in order to stop leakage. It is sold at pharmacies without a prescription.

WHERE CAN ONE PURCHASE URINARY INCONTINENCE PRODUCTS?

The majority of incontinence products are available at the local pharmacy or supermarket and medical supply stores. You can also go for online purchase. Consult a physician for a list of incontinence products to treat incontinence before making the purchase.

 

WHAT TO LOOK FOR IN INCONTINENCE PRODUCTS?

·      Absorbency: There are various incontinence briefs and pads to absorb different amounts of fluid, dependent on the level of bladder problems. If one cannot get to the bathroom on time, experience more urges, and experiences more leaks, consider more absorbent briefs or pads. They may be bigger, but they allow to keep the total volume of leakage.

·      Daytime vs. Nighttime Protection: Most people prefer light coverage during the day and more absorbent choices for the night. The night time protection of bed pads is an excellent option for providing peace of mind when sleeping and not worrying about ruining the sheets.

·      Disposable vs. Reusable: Diapers, pads, liners, or underwear are available that can be cleaned and reused or recycled after just one use. Bed pads are disposable or washable; depending on the use frequency, it is possible to choose the washable option. If one is looking for wearing protection, consider how often one will have to use the products for incontinence and the times of the day when they require them the most.

In summary, the factors to keep in mind when choosing the best incontinence pads:

  • Amount of urine one loses
  • Comfort
  • Cost
  • Durability
  • Simplicity
  • Effectiveness in getting rid of the odor
  • How often do one experiences urine loss.

 



[1] Haylen, B. T. et al. An International Urogynecological Association (IUGA)/International Continence Society

(ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol. Urodyn. 29, 4–20 (2009).

[2] Yoshitaka Aoki, Heidi W. Brown, Linda Brubaker, Jean Nicolas Cornu, J. Oliver Daly and Rufus Cartwright. Urinary incontinence in women.  Nature Reviews, Disease Primers Volume 3. Article Number 17042. https://doi.org/10.1038/nrdp.2017.42

[3] Ruby, C. M. et al. The effect of medication use on urinary incontinence in community-dwelling elderly women. J. Am. Geriatr. Soc. 58, 1715–1720 (2010).

[4] Rait, G. et al. Prevalence of cognitive impairment: results from the MRC trial of assessment and management of older people in the community. Age Ageing 34, 242–248 (2005).

[5] . Lucas, M. G. et al. EAU guidelines on assessment and nonsurgical management of urinary incontinence. Eur. Urol. 62, 1130–1142 (2012)

[6] Saarni, S. I. et al. The impact of 29 chronic conditions on health-related quality of life: a general population survey in Finland using 15D and EQ-5D. Qual. Life Res. 15, 1403–1414 (2006).

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