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Urinary incontinence is the inability to control urination. The term may be used interchangeably with OverActive Bladder (OAB) which also includes the same frequency in urination and urinary urge.
People who suffer from overactive bladder, or urinary incontinence, can't hold their urine -- they wet themselves. (Leaking urine is normal only in infants; it is not a normal result of aging. If you have this problem, you may be too embarrassed or upset to ask for help.
Hattat Hospital is a urology hospital where all the appropriate tests including video-urodinamy are performed to determine not only the type /cause of the incontinence, but also the treatment option for it (medical or surgery).
Incontinence is classified by the symptoms of or circumstances occurring at the time of urine leakage.
- Stress incontinence may be due to poor bladder support by the pelvic muscles or to a weak or damaged sphincter. This condition allows urine to leak when you do anything that strains or stresses the abdomen, such as coughing, sneezing, laughing, or even walking.
- Urge incontinence results when an overactive bladder contracts without your wanting it to do so. You may feel as if you can't wait to reach a toilet. At times, you may leak urine without any warning at all. A bladder can become overactive because of infection that irritates the bladder lining. The nerves that normally control the bladder can also be responsible for an overactive bladder. In other cases, the cause may be unclear.
- Mixed incontinence is often a combination of both conditions above -- stress and urge incontinence.
- Overflow incontinence occurs when the bladder is allowed to become so full that it simply overflows. This happens when bladder weakness or a blocked urethra prevents normal emptying. An enlarged prostate can result in such blockage. For this reason, overflow incontinence is more common in men that in women. Bladder weakness can develop in both men and women, but it happens most often in people with diabetes, heavy alcohol users, and others with decreased nerve function.
- Environmental incontinence (sometimes called functional incontinence) occurs when people cannot get to the toilet or get a bedpan when they need it. The urinary system may work well, but physical or mental disabilities or other circumstances prevent normal toilet usage.
- Nocturnal enuresis is incontinence that occurs during sleep.
Urodynamic testing
When individuals have two or more types of incontinence, the causes of each must be found and considered in planning appropriate treatment.Depending upon the type and suspected causes of your particular incontinence, some of the following tests may be performed at Hattat Hospital to help your health care provider choose a treatment that is right for you.
- Urodynamic testing provides a more advanced way to check bladder function. It may be done if the above tests do not give an answer to why you have leakage of urine or your health professional suspects that you have mixed incontinence with more than one cause. The actual tests done in urodynamic testing often vary. They may include postvoid residual (PVR) measurements and X-rays or ultrasound to examine changes in the position of the bladder and urethra during urination, coughing, or straining.
- Urodynamic testing may also include cystometry (cystometrography, uroflowmetry), a series of tests to measure bladder pressure at different levels of fullness. Cystometry is helpful in diagnosing urge incontinence.3 Cystometry tests include:
-Leak point pressure (LPP), which measures weakness in the muscle that holds back urine (sphincter).
-Maximum urethral closure pressure (MUCP), which measures the pressure keeping the urethra closed naturally.
- Urodynamic testing is expensive and is generally done only if surgery is being considered or if you don't respond to other treatment.
- If the underlying cause of incontinence is not identified by the above tests, more extensive tests may be needed. The following tests are not routinely done to diagnose urinary incontinence.
- Cystoscopy uses a scope to look inside the urethra and the bladder for abnormalities.
- Voiding cystourethrogram is an X-ray that uses an iodine-containing contrast liquid to show the shape of the lower urinary tract (bladder and urethra). This may make visible any physical abnormalities of the urinary tract that could be contributing to incontinence.
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