Incontinence: Types, Causes, and Treatments
What is incontinence? Incontinence refers to the inability to control the evacuation of bodily fluids and waste products. Women and the elderly are the most common group affected with this condition. Although incontinence is not a life-threatening condition, it can lead to more serious physical and psychological health problems. Frequent leaking of urine and feces can lead to recurring infections, skin rashes, and vaginal irritations. It also causes feelings of shame, low-self esteem, and even depression, which lower the quality of one’s life.
Having a better understanding of what this defect is can help you and your loved ones deal with it profoundly.
Types
For most people, incontinence is equivocal to urinary incontinence or uncontrolled passing of urine. However, urinary or bladder incontinence is the most common type of this defect. The types of incontinence depends on what fluid the body is involuntarily releasing – urine, feces, semen, and sometimes mixed. For patients with mixed incontinence, both bowel and urinary control are defective.
Causes
- Diseases. Contrary to what most people think, incontinence is not a disease, but a symptom of a disease. Urinary incontinence is a manifestation of urinary tract infections, Benign Prostatic Hyperplasia (BPH) and prostate cancer in men, and loss of tone in the sphincter muscles. Patients with diarrhea, rectal cancer, damage to the rectal nerves, Parkinson’s disease, and anal sphincter injuries experiences bowel incontinence.
- Surgery and other medical procedures. Surgeries aimed at treating hemorrhoids can damage the rectal muscles and nerves which normally controls defecation. Additionally, removing catheters can temporarily cause urinary incontinence in men and women.
- Aging. With aging comes degeneration of bodily processes, including normal bladder and bowel control. Ageing causes weakening of the muscles in the urinary sphincter and anal sphincter which are normally rigid when people are younger.
- Pregnancy. Pregnancy is the most common cause of incontinence in women. The growing uterus exerts pressure on the bladder and limits the bladder’s capacity to hold urine. Normal bladder functions and urine control resumes after delivery.
Treatments
- The best treatment for incontinence is providing a cure for the underlying disease. Underlying diseases like UTI should be treated with antibiotics, chemotherapy for rectal cancer, and other appropriate treatments needed.
- Taking prescribed medications. These drugs works in three ways: reducing bladder muscle spasms, promoting bladder muscle relaxation, and constricting anal and urinary sphincters. Antispasmodics, anticholinergics, and topical estrogen are the most common drugs in treating incontinence.
- Interventional therapies like sacral nerve stimulation, botulinum toxin injection, and bulking agents. Sacral nerve stimulation applies electrical impulses to the sacral nerve, the nerve that controls passing of urine to reduce incontinence. Botulinum toxin injection reduces muscle spasms to the muscles in the bladder. Lastly, bulking agents like collagen are injected in the tissues around the urethral sphincter to keep it closed and prevent urine from leaking.
- Surgery. Surgical procedures are geared towards supporting weak bladder or rectal muscles, removing blockages, and replacing the urinary sphincter with an artificial one, and changing bladder position. When other non-invasive treatments for incontinence fails, these surgeries may offer the best treatment options.
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