Urinary Incontinence

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UROLOGIC HEALTH URINARY INCONTINENCE Urinary incontinence is the loss of bladder control. As a result, Normally the bladder a person may leak urine by accident. Urinary incontinence can can hold between 10 - 17 range from mild leaking to uncontrollable wetting. fluid ounces. However, the urge for urination E OF occurs when the bladder E SIZ A LA TH RG is about 1/4 full. IS E R G E R D A D P A E 6 risk factors for L F R B U urinary incontinence: E I T H . T 1. age 2. gender I t . l l i s 3. being overweight u a f b n o e 4. smoking u h t 2 w s in e 5. family history h ch c e in s 6 6. health conditions lo o ng t , b up ut can stretch like diabetes 33 40 30 MILLION PERCENT PERCENT Estimated number of U.S. women of U.S. men of people in the affected by affected by U.S. who have overactive overactive overactive bladder. bladder. bladder. National Headquarters: 1000 Corporate Boulevard, Linthicum, MD 21090 Phone: 410-689-3990 • Fax: 410-689-3878 • 1-800-828-7866 • [email protected] • www.UrologyHealth.org UrologyCareFoundation @UrologyCareFdn @UrologyCareFdn UrologyCareFoun Urinary Incontinence COMMON TYPES OF Estimated number of people URINARY INCONTINENCE: worldwide who have urinary 200 incontinence. • Stress incontinence. When urine leaks when MILLION there’s pressure on the bladder like during exercise, coughing, sneezing, laughing, or lifting heavy objects. • Urge incontinence, also known as overactive bladder. When you have a sudden need to urinate and urine leaks out. If you have urinary • Overflow incontinence. When the body makes incontinence, limit more urine than the bladder can hold or the your intake of bladder gets too full, which causes leaking or “dribbling”. alcohol, caffeine, • Functional incontinence. When older people and carbonated who have normal bladder control, but have problems getting to the toilet in time because drinks like soda and of health conditions like arthritis that make it sparkling water. hard to move quickly. • Mixed incontinence. When you experience They can irritate more than one type of urinary incontinence. your bladder. MEN AND URINARY INCONTINENCE FACTS An enlarge prostate, also known as 1 benign prostatic hyperplasia (BPH), may cause urinary incontinence TREATMENTS FOR The side effects of prostate cancer URINARY INCONTINENCE: 2 treatment may also cause urinary 1. Lifestyle changes 4. Medications incontinence in some men. 2. Kegel exercises 5. Devices 3. Physical therapy 6. Surgery groups commonly affected by Products such as absorbent pads and adult diapers urinary incontinence are adults can also help manage incontinence. Talk to your © 2018 Urology Care Foundation Care © 2018 Urology over the age of 70 and women. doctor about the right option for you. National Headquarters: 1000 Corporate Boulevard, Linthicum, MD 21090 Phone: 410-689-3990 • Fax: 410-689-3878 • 1-800-828-7866 • [email protected] • www.UrologyHealth.org UrologyCareFoundation @UrologyCareFdn @UrologyCareFdn UrologyCareFoun.

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Urinary Incontinence
GLICKMAN UROLOGICAL & KIDNEY INSTITUTE Urinary Incontinence What is it? can lead to incontinence, as can prostate cancer surgery or Urinary incontinence is the inability to control when you radiation treatments. Sometimes the cause of incontinence pass urine. It’s a common medical problem. As many as isn’t clear. 20 million Americans suffer from loss of bladder control. The condition is more common as men get older, but it’s Where can I get help? not an inevitable part of aging. Often, embarrassment stops Talking to your doctor is the first step. You shouldn’t feel men from seeking help, even when the problem is severe ashamed; physicians regularly help patients with this prob- and affects their ability to leave the house, spend time with lem and are comfortable talking about it. Many patients family and friends or take part in everyday activities. It’s can be evaluated and treated after a simple office visit. possible to cure or significantly improve urinary inconti- Some patients may require additional diagnostic tests, nence, once its underlying cause has been identified. But which can be done in an outpatient setting and aren’t pain- it’s important to remember that incontinence is a symp- ful. Once these tests have determined the cause of your tom, not a disease. Its cause can be complex and involve incontinence, your doctor can recommend specific treat- many factors. Your doctor should do an in-depth evaluation ments, many of which do not require surgery. No matter before starting treatment. how serious the problem seems, urinary incontinence is a condition that can be significantly relieved and, in many What might be causing my incontinence? cases, cured.
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Urinary Incontinence Embarrassing but Treatable 2015 Rev
This information provides a general overview on this topic and may not apply to Health Notes everyone. To find out if this information applies to you and to get more information on From Your Family Doctor this subject, talk to your family doctor. Urinary incontinence Embarrassing but treatable 2015 rev. What is urinary incontinence? Are there different types Urinary incontinence means that you can’t always of incontinence? control when you urinate, or pee. The amount of leakage Yes. There are five types of urinary incontinence. can be small—when you sneeze, cough, or laugh—or large, due to very strong urges to urinate that are hard to Stress incontinence is when urine leaks because of control. This can be embarrassing, but it can be treated. sudden pressure on your lower stomach muscles, such as when you cough, sneeze, laugh, rise from a Millions of adults in North America have urinary chair, lift something, or exercise. Stress incontinence incontinence. It’s most common in women over 50 years usually occurs when the pelvic muscles are weakened, of age, but it can also affect younger people, especially sometimes by childbirth, or by prostate or other pelvic women who have just given birth. surgery. Stress incontinence is common in women. Be sure to talk to your doctor if you have this problem. Urge incontinence is when the need to urinate comes on If you hide your incontinence, you risk getting rashes, too fast—before you can get to a toilet. Your body may only sores, and skin and urinary tract (bladder) infections.
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Frequently Asked Questions About Overactive Bladder
ABOUT OAB Frequently Asked Questions about Overactive Bladder What is Overactive Bladder (OAB)? If you live with OAB, you may also: Overactive Bladder (OAB) isn’t a disease. It’s the u Leak urine (incontinence): Sometimes people name of a group of urinary symptoms. The most with OAB also have “urgency incontinence.” common symptom of OAB is a sudden urge to This means that urine leaks when you feel urinate that you can’t control. Some people will the sudden urge to go. This isn’t the same as leak urine when they feel this urge. Having to “stress urinary incontinence” or “SUI.” People urinate many times during the day and night is with SUI leak urine while sneezing, laughing or another symptom of OAB. doing other physical activities. (You can learn more about SUI at UrologyHealth.org/SUI.) How common is OAB? u Urinate frequently: You may also need to go OAB is common. It affects millions of Americans. to the bathroom many times during the day. As many as 30 percent of men and 40 percent The number of times someone urinates varies of women in the United States live with OAB from person to person. But many experts symptoms. agree that going to the bathroom more than eight times in 24 hours is “frequent urination.” Who is at risk for OAB? u Wake up at night to urinate: Waking from As you grow older, you’re at higher risk for sleep to go to the bathroom more than once a OAB. But no matter what your age, there are night is another symptom of OAB.
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Diagnosis and Management of Urinary Incontinence in Childhood
Committee 9 Diagnosis and Management of Urinary Incontinence in Childhood Chairman S. TEKGUL (Turkey) Members R. JM NIJMAN (The Netherlands), P. H OEBEKE (Belgium), D. CANNING (USA), W.BOWER (Hong-Kong), A. VON GONTARD (Germany) 701 CONTENTS E. NEUROGENIC DETRUSOR A. INTRODUCTION SPHINCTER DYSFUNCTION B. EVALUATION IN CHILDREN F. SURGICAL MANAGEMENT WHO WET C. NOCTURNAL ENURESIS G. PSYCHOLOGICAL ASPECTS OF URINARY INCONTINENCE AND ENURESIS IN CHILDREN D. DAY AND NIGHTTIME INCONTINENCE 702 Diagnosis and Management of Urinary Incontinence in Childhood S. TEKGUL, R. JM NIJMAN, P. HOEBEKE, D. CANNING, W.BOWER, A. VON GONTARD In newborns the bladder has been traditionally described as “uninhibited”, and it has been assumed A. INTRODUCTION that micturition occurs automatically by a simple spinal cord reflex, with little or no mediation by the higher neural centres. However, studies have indicated that In this chapter the diagnostic and treatment modalities even in full-term foetuses and newborns, micturition of urinary incontinence in childhood will be discussed. is modulated by higher centres and the previous notion In order to understand the pathophysiology of the that voiding is spontaneous and mediated by a simple most frequently encountered problems in children the spinal reflex is an oversimplification [3]. Foetal normal development of bladder and sphincter control micturition seems to be a behavioural state-dependent will be discussed. event: intrauterine micturition is not randomly distributed between sleep and arousal, but occurs The underlying pathophysiology will be outlined and almost exclusively while the foetus is awake [3]. the specific investigations for children will be discussed. For general information on epidemiology and During the last trimester the intra-uterine urine urodynamic investigations the respective chapters production is much higher than in the postnatal period are to be consulted.
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Chapter 31: Lower Urinary Tract Conditions in Elderly Patients
Chapter 31: Lower Urinary Tract Conditions in Elderly Patients Damon Dyche and Jay Hollander William Beaumont Hospital, Royal Oak, Michigan As our population ages, the number of patients pre- uroflow/urodynamic studies, and cystoscopy. Com- senting to their primary care physicians with uro- mon transurethral treatment modalities include re- logic problems is significantly increasing. Urologic section, laser ablation, and microwave or radiofre- issues are the third most common type of complaint quency therapy. in patients 65 yr of age or older and account for at There are two major approaches of medical ther- least a part of 47% of office visits.1 One of the most apy for prostatic outflow obstruction: relaxing the predominant urologic problems in elderly persons, prostate smooth muscle tissue or decreasing glan- ␣ and the focus of this chapter, is lower urinary tract dular volume. 1-adrenergic blockade relaxes the symptoms (LUTS). There are several disease pro- smooth muscle fibers of the prostatic stroma and cesses that can lead to LUTS, as well as a number of can significantly improve urine flow. Because ␣ consequences. In this chapter, we will give a brief blockade can also have significant cardiovascular ␣ overview of the major issues as they relate to elderly side effects, 1 selective medications were devel- persons. oped to specifically target the urinary system. Com- mon nonselective agents include terazosin and dox- azosin; selective medications are tamsulosin and BENIGN PROSTATIC HYPERPLASIA AND alfuzosin. 5-␣ reductase inhibitors block the con- LUTS version of testosterone 3 DHT, which is a potent stimulator of prostatic glandular tissue. This reduc- The prostate surrounds the male urethra between tion in local androgen stimulation results in a pro- the bladder neck and urinary sphincter like a gressive decrease in prostatic volume over a period doughnut.
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What I Need to Know About Bladder Control for Women
What I need to know about BladderBladder ControlControl forfor WomenWomen U.S. Department NATIONAL INSTITUTES OF HEALTH of Health and National Kidney and Urologic Diseases Information Clearinghouse Human Services What I need to know about Bladder Control for Women NATIONAL INSTITUTES OF HEALTH National Diabetes Information Clearinghouse Contents Urine Leakage: A Common Health Problem for Women of All Ages ................................................................ 1 How does the bladder work?................................................. 2 What are the different types of bladder control problems? ................................................................................ 5 What causes bladder control problems? .............................. 7 How do I tell my health care team about my urine leakage?................................................................................... 9 How is loss of bladder control treated?.............................. 11 Hope Through Research...................................................... 17 For More Information.......................................................... 18 Acknowledgments................................................................. 19 *Inserts in back pocket A. What Your Doctor Needs to Know B. Your Daily Bladder Diary C. Kegel Exercise Tips D. Medicines for Bladder Control Urine Leakage: A Common Health Problem for Women of All Ages You may think bladder control problems are something that happen when you get older. The truth is that women of all ages have urine
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The Morbidity Due to Lower Urinary Tract Function in Spinal Cord Injury Patients
Paraplegia 31 (1993) 320-329 © 1993 International Medical Society of Paraplegia The morbidity due to lower urinary tract function in spinal cord injury patients P E V Van Kerrebroeck MD PhD, E L Koldewijn MD, S Scherpcnhuizen, F M J Debruyne MD PhD Department of Urology, Unit for Neurourology and Urodynamics, University Hospital St Radboud, Geert Grooteplein Zuid 16, PO Box 9101, NL-6500 HB Nijmegen, The Netherlands. A review is given of 105 patients with a traumatic spinal cord injury. In 93 patients with a minimum follow up of one year the morbidity due to lower urinary tract function was evaluated, based on the situation at their last control visit. The relation was studied between bladder behaviour and the type of urine evacuation and their influence on upper urinary tract problems, urinary tract infections, stone formation and incontinence. Based on the results of this study the most appropriate method for control of bladder behaviour and urine evacuation in spinal cord injured patients is discussed in view of new treatment modalities such as dorsal rhizotomies and the implantation of an anterior sacral root stimulator. Keywords: spinal cord injuries; neurogenic lower urinary tract dysfunction; morbidity. Introduction daily practice proves that the control of individual patients tends to be less scrupul Great progress has been made during the ous with time. Even in the published pros last 25 years in the urological rehabilitation pective series the incidence of urological of patients with a spinal cord injury. problems varies much depending on the Nevertheless these patients continue to follow up, the composition of the patient develop complications such as urinary groups and the treatment(s) that were prop tract infections, stones of the upper and osed.
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The Evaluation and Treatment of Urinary Incontinence in Women: a Primary Care Approach
J Am Board Fam Pract: first published as 10.3122/jabfm.5.3.289 on 1 May 1992. Downloaded from The Evaluation And Treatment Of Urinary Incontinence In Women: A Primary Care Approach Mark D. Walters, M.D., andJanet P. Realini, M.D. Abslrtlet: llIIcllgroutul: Urinary incon1inence, the involun1ary loss of urine severe enough to have adverse social or hygleoic consequences, is a major clinical problem and a significant cause of disability and dependency. At least 10 million adults in the US suft'er &om urinary incontinence, including III eBdmated 15 to 30 percent of community-dwelling older persons. In spite of its high rate of occurrence, fewer than one-half of women with regular urinary incontinence seek medical help for their problem, either because of embarrassment or the perception that their symptoms are normal. Metbods: MEDUNE files were sea.rched from 1970 to 1990 using the key words "incontinence," "prevalence," and "diagnosis" and for specitlc nonsurgical treatments. Only articles pertaining to adult women were chosen. ReSlllts tmtl CtmelflSlmIs: Urinary incontinence frequently can be diagnosed accurately by family physicians using basic tests in the office. Many women experience improvement of incontinence with properly employed behavioral and pharmacologic therapy. Other women bendlt &om referral for specialized evaluation and consideration for surgical therapy. (J Am Board Pam Prac:t 1992; 5:289-301.) Urinary incontinence is a common problem sionalleaking with cough, laugh, or sneeze; more among women - and one that often goes
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Guidelines on Urinary Incontinence M.G
Guidelines on Urinary Incontinence M.G. Lucas (Chair), D. Bedretdinova (Guidelines Associate), L.C. Berghmans, J.L.H.R. Bosch, F.C. Burkhard, F. Cruz, A.K. Nambiar, C.G. Nilsson, A. Tubaro, R.S. Pickard © European Association of Urology 2015 TABLE OF CONTENTS PAGE 1. INTRODUCTION 6 1.1 Aim 6 1.1.1 Use in different healthcare settings and by healthcare professionals 6 1.2 Publication history 6 1.3 Panel composition 7 2. METHODS 7 2.1 PICO questions 7 2.2 Search strategies 7 2.3 Terminology 8 3. DIAGNOSTIC EVALUATION 9 3.1 History and physical examination 9 3.2 Patient questionnaires 9 3.2.1 Questions 9 3.2.2 Evidence 9 3.3 Voiding diaries 12 3.3.1 Questions 12 3.3.2 Evidence 12 3.4 Urinalysis and urinary tract infection 12 3.4.1 Questions 12 3.4.2 Evidence 13 3.5 Post-voiding residual volume 13 3.5.1 Question 13 3.5.2 Evidence 13 3.6 Urodynamics 13 3.6.1 Question 14 3.6.2 Evidence 14 3.6.2.1 Variability 14 3.6.2.2 Diagnostic accuracy 14 3.6.2.3 Does urodynamics influence the outcome of conservative therapy 14 3.6.2.4. Does urodynamics influence the outcome of surgery for stress urinary incontinence? 14 3.6.2.5 Does urodynamics help to predict complications of surgery? 14 3.6.2.6 Does urodynamics influence the outcome of surgery for detrusor- overactivity? 15 3.6.2.7 Does urodynamics influence the outcome of treatment for post- prostatectomy urinary incontinence in men? 15 3.7 Pad testing 15 3.7.1 Question 16 3.7.2 Evidence 16 3.8 Imaging 16 3.8.1 Questions 16 3.8.2 Evidence 16 4.
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What Is the Most Effective Treatment for Nocturia Or Nocturnal Incontinence in Adult Women?
EUF-869; No. of Pages 11 E U R O P E A N U R O L O G Y F O C U S X X X ( 2 0 1 9 ) X X X – X X X ava ilable at www.sciencedirect.com journa l homepage: www.europeanurology.com/eufocus Review What Is the Most Effective Treatment for Nocturia or Nocturnal Incontinence in Adult Women? a, b c d Dina Bedretdinova *, David Ambu¨hl , Muhammad Imran Omar , Vasileios Sakalis , e f g h Nikesh Thiruchelvam , Marc Schneider , Arjun Nambiar , Ruud Bosch a b c INSERM CESP U1018, Villejuif, France; Department of Urology, University Hospital Bern, Inselspital Anna Seiler-Haus, Bern, Switzerland; European d Association of Urology Guidelines Office, Arnhem, The Netherlands; Department of Urology, General Hospital of Thessaloniki Agios Pavlos, Thessaloniki, e f Greece; Department of Urology, Cambridge University Hospitals NHS Trust, Cambridge, UK; Department of Urology, University Hospital Bern, Inselspital g h Anna Seiler-Haus, Bern, Switzerland; Department of Urology, Freeman Hospital, Newcastle-upon-Tyne, UK; Department of Urology, University Medical Centre Utrecht, Utrecht, The Netherlands Article info Abstract Article history: Context: Nocturia is a prevalent symptom with varied aetiology and no consensus on treatment options. Accepted January 28, 2020 Objective: We systematically reviewed evidence comparing the beneﬁts and harms of various treatment options for nocturia or nocturnal incontinence in women. Associate Editor: Evidence acquisition: Literature search was performed using Embase, Medline, and Cochrane Malte Rieken databases (from 1 January 1946 to 26 September 2017), following the methods detailed in the Cochrane Handbook. The protocol was registered with PROSPERO.
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Investigation of the Neurogenic Bladder
6 6Journal ofNeurology, Neurosurgery, anid Psychiatry 1996;60:6-13 J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.60.1.6 on 1 January 1996. Downloaded from NEUROLOGICAL INVESTIGATIONS Investigation of the neurogenic bladder Clare J Fowler Methods of examination which have been analogue signals but with the advances in used to investigate the neurogenic bladder electronics and development of microchip include tests of bladder function, so-called technology the machines have become pro- "urodynamics", and neurophysiological tests gressively more complex, more "intelligent", of sphincter and pelvic floor innervation. A and mostly easier to use. Today measured possible consequence of a neurogenic bladder is pressures are digitised allowing on line, real damage to the upper urinary tract but the time computer analysis of signals. investigation of such complications is essen- During the development of urodynamics an tially urological and is only briefly mentioned important advance came with the introduction in this review. of facilities to record pressure measurements superimposed on the fluoroscopic appearances of the bladder, a "videocystometrogram". History of the development of This combination provides a complete picture investigations of the behaviour of the bladder both during URODYNAMICS filling and emptying although it is expensive The term "urodynamics" encompasses any and exposes the patient to x rays. Much can be investigation of urinary tract function although learnt from simple cystometry alone and it is it is often used colloquially as a synonym for this investigation which is now a standard cystometry. Cystometry, the measurement of facility in almost every district general hospital bladder pressure, has been the main tool used with a urology department.
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Urinary Incontinence in Women
Urinary Incontinence in Women National Kidney and Urologic Diseases Information Clearinghouse Millions of women experience involuntary stroke, multiple sclerosis, and physical loss of urine called urinary incontinence problems associated with aging. (UI). Some women may lose a few drops of urine while running or coughing. Others Older women experience UI more often National than younger women. But incontinence Institute of may feel a strong, sudden urge to urinate Diabetes and just before losing a large amount of urine. is not inevitable with age. UI is a medical Digestive problem. Your doctor or nurse can help and Kidney Many women experience both symptoms. Diseases UI can be slightly bothersome or totally you find a solution. No single treatment debilitating. For some women, the risk of works for everyone, but many women can NATIONAL find improvement without surgery. INSTITUTES public embarrassment keeps them from OF HEALTH enjoying many activities with their family Incontinence occurs because of problems and friends. Urine loss can also occur dur with muscles and nerves that help to hold ing sexual activity and cause tremendous or release urine. The body stores urine— emotional distress. water and wastes removed by the kidneys— Women experience UI twice as often as in the bladder, a balloon-like organ. The men. Pregnancy and childbirth, meno bladder connects to the urethra, the tube pause, and the structure of the female uri through which urine leaves the body. nary tract account for this difference. But During urination, muscles in the wall of both women and men can become inconti the bladder contract, forcing urine out of nent from neurologic injury, birth defects, the bladder and into the urethra.
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