Incontinence is broadly defined as an involuntary loss of urine. There are many types of incontinence and they require specific approaches:
• Urge incontinence – In this condition, the bladder is overactive. Patients visit the bathroom frequently, feel “an urge” to urinate, are unable to “hold it” long enough to get to the toilet. Patients often urinate more than eight times per 24-hour period, and awaken more than once during the night to urinate, and can leak a moderate-to-large amount. Treatment may include medication or physical therapy.
• Stress incontinence – In this condition, the urethra is incompetent and won’t remain closed; therefore, the sphincter doesn’t close. Without warning, the person may lose a small volume of urine while laughing, coughing, or jumping or at any time when there is an increase in intra-abdominal pressure. This is a result of weak pelvic floor muscles. Pelvic traumas, such as childbirth or impact injuries, are common causes. This is also the most common form of incontinence after prostate removal for prostate cancer. Treatment may include physical therapy, medication or surgery.
• Overflow incontinence – In this condition, the bladder is under active and does not empty well. Because the bladder does not empty, urine leaks when the bladder reached its full capacity. THis condition can put abnormal pressure on the kidneys and can cause kidney failure. Treatment may involve surgery or catheterization.
• Reflex incontinence – This is a cause of incontinence in patients who have suffered a spinal cord injury from either trauma or other neurologic disease.
• Functional incontinence – This occurs when a patient is unable to get to the bathroom in time.
• Nocturnal Enuresis – Refers to loss of urine at night that occurs without sensation and is seen mainly in children.