Stop Overlooking Signs of Incontinence

Posted on

Sep 14, 2011

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Florida - Southwest

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Urinary Incontinence is a common medial condition that affects over 40 million Americans. It often goes untreated or unrecognized. The reason for this trend is multifactorial; some patients are uncomfortable about discussing these issues.
Nevertheless, it is a treatable condition that frequently affects quality of life. Incontinence is classified as stress, urge, mixed and overflow. In these notes we will discuss issues about urge incontinence.
Urinary urge incontinence (UUI) is defined as a sudden uncontrollable urge to urinate with or without frequent urination and associated leakage of urine. With urge incontinence, the bladder contracts and squeezes out urine involuntarily.
Patients with overactive bladder symptoms, such as urinary urgency, frequency and nocturia, may have associated incontinence over 60% of the time. Though more common in women than men overall, after the age of 70 the prevalence in both sexes is about equal.
There are two bladder abnormalities that are associated to UUI: neurogenic overactivity (nerve related as in Parkinson's, Alzheimer's or strokes) and detrusor overactivity (DO) (related to bladder surgeries, infections, bladder polyps, and prostate problems).
Dietary habits may lead to significant voiding symptoms. Caffeine (e.g., in coffee, tea, chocolate), carbonated beverages, spicy foods and tomato-based foods can irritate the bladder and cause detrusor instability, resulting in urge incontinence.
The treatment and management of urge incontinence includes nonsurgical and surgical modalities. An important factor, however, is identifying the potentially morbid or life-threatening conditions that may lead to incontinence, such as bladder cancer, recurrent UTI or neurogenic disorders.
Anticholinergics have been shown to be very effective in the treatment of both neurogenic and idiopathic cause of UUI. As a class, side effects include confusion, dry mouth, constipation, dizziness, visual changes and urinary retention to name a few. Beyond medications there are simple yet effective treatments.
Advanced treatment modalities for unresponsive patients to conservative therapy and anticholinergics are available in the urologic armamentarium. Urological evaluation of these patients most likely will include a cystoscopy, urine cultures and urine cytology to rule out bladder pathology and bladder malignancies.
Urinary incontinence is a common but overlooked problem. Urologic evaluation is warranted in patients to rule out underlying bladder pathology or anatomical problems. Intervention beyond medications will significantly improve the quality of life of these patients.
Editors Note: This article was submitted by Rolando Rivera, Board Certified M.D., Specialists in Urology 239-434-6300. www.specialistsinurology.com

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