Urinary incontinence is the unintentional loss of urine. Stress incontinence is prompted by a physical movement or activity — such as coughing, sneezing or heavy lifting — that puts pressure (stress) on your bladder. Stress incontinence is not related to psychological stress.
Stress incontinence is much more common in women than in men.
If you have stress incontinence, you may experience urine leakage when you:
Cough
Sneeze
Laugh
Stand up
Lift something heavy
Exercise
You may not experience incontinence every time you do one of these things, but any pressure-increasing activity can make you more vulnerable to unintentional urine loss, particularly when your bladder is full.
Stress incontinence occurs because of poor function in the muscles that support the bladder or control the release of urine. Sometimes both muscle groups are involved. The bladder expands as it fills with urine, but valve-like muscles at either end of the urethra — the short tube through which urine flows to exit your body — normally stay "closed" or contracted, preventing urine release until you reach a bathroom. When the muscles supporting the bladder are weak, however, pressure can trigger urine release before you're ready. Problems with the "valves" themselves (the urinary sphincter) may have the same effect.
Your bladder may not even feel unusually full when you have urine leakage due to stress incontinence. Anything that exerts force on the abdominal muscles — sneezing, bending over, lifting, laughing hard — also puts pressure on your bladder.
Your urinary sphincter and pelvic floor muscles may lose tone because of:
Childbirth. In women, poor function of pelvic floor muscles or the sphincter may occur because of tissue or nerve damage incurred during delivery of a child. Stress incontinence from this damage may begin soon after delivery or years later.
Prostate surgery. In men, the most common factor leading to stress incontinence is the surgical removal of the prostate gland (prostatectomy) to treat prostate cancer. Because the prostate gland encircles the urethra, a prostatectomy results in less urethral support.
Treatments and drugs
Your doctor is likely to recommend a combination of treatment strategies to end or lessen the number of incontinence episodes. If an underlying cause or contributing factor, such as a urinary tract infection, is identified, you'll also receive treatments to address those conditions.
Behavioral therapies
Behavioral therapies may help you eliminate or lessen episodes of stress incontinence. The stress incontinence treatments your doctor will recommend may cover the following areas:
Fluid consumption. Your doctor may recommend the amount and timing of fluid consumption during the day. You should also avoid caffeinated and alcoholic beverages.
Healthy lifestyle changes. Quitting smoking or losing weight may lessen your vulnerability to stress incontinence and improve symptoms if you do have stress incontinence.
Scheduled toilet trips. Your doctor may recommend a schedule for toileting. More frequent voiding of the bladder may reduce the number or severity of stress incontinence episodes.
Pelvic floor muscle exercises. Exercises called Kegels strengthen your pelvic floor muscles and urinary sphincter. Your doctor or a physical therapist can help you learn how to do these exercises correctly. How well Kegels will work for you depends on your willingness to perform the exercises regularly, just like any other exercise routine.
Devices
Certain devices designed for women may help control stress incontinence, including:
Vaginal pessary. This ring-shaped device, fitted and put into place by your doctor or nurse practitioner, helps support your bladder to prevent urine leakage. A vaginal pessary may be a good choice if you wish to avoid surgery.
Urethral plug. This small tampon-like disposable device inserted into the urethra acts as a plug to prevent leakage. It's usually used to prevent incontinence during a specific activity.
SurgerySurgical interventions to treat stress incontinence are generally designed to improve closure of the sphincter or support the bladder neck. Surgical interventions include:
Injectable bulking agents. Collagen, synthetic sugars or gels may be injected into tissues around the upper portion of the urethra. These materials increase pressure on the urethra, improving the closing ability of the sphincter. Because this intervention is relatively noninvasive and inexpensive, it may be an appropriate treatment alternative to try before other surgical options.
Open retropubic colposuspension. This procedure is often used to treat women with stress incontinence. Sutures attached either to ligaments or to bone lift and support tissues near the bladder neck and upper portion of the urethra.
Sling procedure. In this procedure most often performed for women, the surgeon uses the person's own tissue or a synthetic material to create a "sling" that supports the urethra. Slings for men are used less frequently, but this surgical approach is under investigation. A recently developed technique using a mesh sling has proved effective in easing symptoms of stress incontinence in men.
Inflatable artificial sphincter. This surgically implanted device is more often used to treat men. A cuff, which fits around the upper portion of the urethra, replaces the function of the sphincter. Tubes connect the cuff to a pressure-regulating balloon in the pelvic region and a manually operated pump in the scrotum. If the device is implanted in a woman, the pump is in the labia.
Lifestyle and home remedies
Healthy lifestyle practices can go a long way toward easing symptoms of stress incontinence.
Shed extra weight. If you're overweight — your body mass index (BMI) is over 25 — losing excess pounds can help reduce the overall pressure on your bladder and pelvic floor muscles. Losing 5 to 10 percent of your body weight may help improve your stress incontinence.
Add fiber to your diet. Constipation contributes to incontinence, especially if you often strain during bowel movements. Keeping your bowel movements soft and regular allows urine to flow freely and reduces the strain that's placed on your pelvic floor muscles. Eat high-fiber foods — whole grains, legumes, fruits and vegetables — to relieve and prevent constipation.
Avoid eating or drinking substances that can irritate your bladder. For instance, if you know that drinking coffee throughout the day tends to make you go to the bathroom more frequently, try reducing the amount you drink.
Maintain proper fluid intake. Drinking too much fluid can make you urinate more frequently. But not drinking enough can lead to a concentration of waste in your urine, which can irritate your bladder, too.
Don't smoke. Smoking can lead to a severe chronic cough, which can aggravate the symptoms of stress incontinence.
Homeopathic Remedies
Squilla, Causticum , Pulsatilla, Natrum mur, Zincum met
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