Managing Urinary Incontinence

The term, management, in medical terminology refers to the diagnosis and treatment of a disease or a condition, which is crucial to the success in managing incontinence. Simply stated a urinary incontinence condition cannot be managed if not properly identified and diagnosed.

The diagnosis of incontinence is not self-evident. Many patients suffering from urinary incontinence assume it to be somehow a natural part of ageing. Females are especially prone to incontinence, because of the stresses that pregnancy and childbirth place on a woman’s internal organs. This leakage, frequently occurring upon sneezing, coughing or straining, is not identified by female sufferers as incontinence per se, and consequently they do not ask their doctors about possible available treatments and intervention.

Another common belief is that people in their old age may have to suffer through incontinence, because, much like losing muscular strength, nothing can be done about it except managing the condition with incontinence products. Incontinence is not a normal part of ageing, and any delay in diagnosing the underlying causes of incontinence delays managing the condition and needlessly prolongs the patient’s misery.

Once the diagnosis of incontinence is established, its type is determined by the physician. There are different management strategies according to the type of incontinence, which is determined through history taking and patient questionnaires. Information such as when and how the leakage occurs and the presence of any accompanying symptoms is of essential value in determination of the type and cause of incontinence. Physical examination by the physician; and, in many instances laboratory or urodynamic tests, may be necessary to detect any associated or causative abnormalities. The nature of the examination and required tests depend upon the patients’ ages as well as their symptoms.
Some cases of incontinence are noted by the physician to be transient and are managed conservatively. In other instances, managing incontinence is achieved through addressing the underlying causes, such as the presence a urinary tract infection or even incontinence caused by depression.

Another essential part of managing incontinence is a thorough review of the medication intake of the patient. Bladder control is achieved through the ability to maintain the bladder sphincter contracted and the bladder wall relaxed until voluntary voiding is requested. When voiding the bladder, the opposite occurs. The bladder wall contracts squeezing the content and the sphincter relaxes allowing the urine to follow out. Both the wall of the bladder and the muscular sphincter of the urinary bladder express receptors, which cause its contraction or relaxation. Many drugs can cause or aggravate urinary incontinence through their effects on bladder receptors. Drugs inhibiting the contraction of the bladder sphincter may cause or aggravate stress incontinence. Bladder stimulants, such as caffeine, render the muscular wall of the bladder hypersensitive and increase the bladders ability to contract. The list of medications and chemical compounds affecting bladder activity is very long, and so it is important for patients suffering from incontinence to disclose to their treating physicians a detailed account of their non-prescription as well as prescription drugs.

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