Incontinence

Urinary incontinence is the involuntary loss of urine. More than 12 million Americans are estimated to have urinary incontinence. Incontinence affects all ages, including 15 percent to 30 percent of people over age 60 who live at home and half of those residing in nursing homes. Women are affected twice as often as men. Because of the social stigma, many do not even report the problem.

Types of Incontinence
1. Stress incontinence is the loss of urine during coughing, laughing, or other physical activities that increase abdominal pressure.
2. Urge incontinence is the loss of urine with a sudden and severe desire to void.
3. Overflow incontinence occurs when the bladder becomes so full that it simply overflows.
4. Transient incontinence results from something that can be easily reversed.
Sometimes incontinence can be a mixture of more than one of the four types.

Evaluation
1. Detailed history and physical exam
2. Urinalysis
3. Post-void residual (PVR)
A more detailed evaluation may require a voiding diary, cystoscopy, intravenous pyelogram (IVP), and urodynamic testing.

Treatment
1. Behavioral techniques
2. Medications
3. Surgery

There are three main types of treatment for incontinence. The best treatment for each patient depends on the specific type of incontinence.

Incontinence is a problem that affects one’s emotional, psychological and social well-being. It can make people afraid to participate in normal daily activities. It is particularly important to note that the great majority of incontinence causes can be treated successfully.