| General
Illness Information |
Medical Term: |
INCONTINENCE,
STRESS |
|
Common
Name: |
None Specified |
| Description: |
| Involuntary loss of bladder control and
passage of urine in conditions of high abdominal pressure or
stress (coughing, sneezing, lifting, etc.). |
| Commonest in post-menopausal women. |
|
| Causes: |
| Loss of pelvic support with age, childbirth
and surgery . |
| Damage to sphincter control mechanisms in
males (rare). |
|
| Prevention: |
| Eat a normal, well-balanced diet and exercise
regularly to build and maintain muscle strength. |
| Regular physical exams in males and females
to detect any early problems. |
| Females can learn and practice Kegel
exercises after childbirth. |
| Kegel exercises: |
| Females can learn to recognize, control and
develop the muscles of the pelvic floor. These are the ones
you use to interrupt urination in mid-stream. The following
exercises strengthen these muscles so you can control or relax
them completely: |
| To identify which muscles are involved,
alternately start and stop urinating when using the toilet. |
| Practice tightening and releasing the muscles
while sitting, standing, walking, driving, watching TV or
listening to music. |
| Tighten the muscles a small amount at a time,
"like an elevator going up to the 9th floor". Then
release very slowly, "one floor at a time". |
| Tighten the muscles from front to back,
including the anus, as in the previous exercises. |
| Practice exercises every morning, afternoon
and evening. Start with 5 times each, and gradually work up to
20 or 30 each time. |
|
| Signs
& Symptoms |
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| Loss of control of bladder function during periods of
increased intra-abdominal pressure. This results in
unintentional loss of urine with lifting, sneezing,
singing, coughing, laughing, crying or straining to have
a bowel movement. |
| This may progress to the point where the patient is
afraid to venture outdoors or to socialize. |
|
|
| Risk
Factors |
|
|
| Diagnosis & Treatment |
| The
diagnosis is usually made by the history. |
| General
Measures: |
 |
Pelvic floor exercises (Kegel's
exercises). |
|
Good perineal hygiene. |
|
Incontinence pads |
|
Frequent emptying of the bladder. |
|
| Medications: |
|
Antibiotics for any inter-current
urinary-tract infection. |
|
Sympathomimetic drug therapy, which
helps increase the tone of urethral muscles, may be
prescribed. |
|
Estrogen therapy may be prescribed. |
|
| Activity: |
|
No restrictions. | |
| Diet: |
|
Lose weight if you are overweight. |
|
Decrease amount of caffeine and
alcohol in your diet. |
|
Avoid high volume of fluid intake
in situations where access to bathroom facilities is limited
(airplane trips). |
|
| Possible
Complications : |
|
Complete loss of urinary control.
This requires surgery. |
|
Urinary-tract infections
(recurrent). |
|
Social isolation as mentioned
above. |
|
| Prognosis |
| If the stress
incontinence is not severe enough to require surgery, exercise
can improve the muscle function. If it is severe, it can be
cured with surgery | |
| Other |
|
|