Incontinence of Urine, Involuntary Loss of Urine - Causes, Treatment

The condition you have is called as incontinence of urine where there is involuntary loss of urine.

Causes of Incontinence of urine:

Non-neuropathic incontinence:

1. Urge incontinence - is almost always associated with frequency and urgency and commonly nocturnal.

   Causes of Urge Incontinence:

   • Detrusor muscle (bladder muscle) instability.
     
     
     
   • Bladder hypersensitivity due to urinary tract infection, bladder stones, interstitial cystitis, post-radiotherapy cystitis and tuberculosis.
2. Post-micturation dribbling- occurs in men when they have finished voiding. The urethra empties its urine content as a result of gravity and movement, because the bulbospongiosus muscle fails to do this.
   
   
   
3. Insensible incontinence- this usually results from stress leakage of small amounts of urine and is the most common cause of incontinence of urine nowadays. It may occur in men with chronic retention and overflow which may be the result of combination of impaired detrusor contractility, outflow obstruction and often impaired bladder sensation.
4. Total incontinence- means there is constant dribbling of urine with no distinct voiding episodes.

   Causes of Total Incontinence:

   • fistulas, neuropathic bladder dysfunction, post-prostatectomy splinter weakness, chronic retention with overflow can cause incontinence
5. Bed wetting- is sometimes associated with frequency, urgency and daytime urge incontinence in persons with detrusor instability, more often it occurs because of impaired nervous system control of bladder.
6. Antisocial incontinence- occurs when the individual has lost the ability to appreciate the need to void in a specific placement for the purpose.

Neuropathic bladder dysfunction:

1. Suprapontine lesions e.g. strokes, trauma, tumors and Parkinson’s disease.
2. Cord lesions- detrusor activity is involuntary, but may be in-coordinated with distal sphincter activity, so that the two act together during voiding, causing high-pressure outflow obstruction which may cause obstructive uropathy.
3. Peripheral lesions such as trauma (e.g. pelvic fractures) and diabetes mellitus.

Treatment of Incontinence of Urine:

1. Stress incontinence
2. Detrusor instability- may respond to bladder drill. Person is instructed to increase time interval between voids until normal voiding frequency is established. For more severe cases anti-cholinergic e.g. oxybutyrin is given. Surgery if drug treatment fails.
3. Bladder hypersensitivity- treatment of cause if small fibrotic bladder (e.g. interstitial cystitis) and substitution cystoplasty.
4. Neuropathic incontinence- for involuntary detrusor activity anti-cholinergic drugs, for acontractile bladder clean intermittent self-catheterization and for incontinence with small dementia special pads and pants.

Home remedies for Incontinence of Urine:

1. A teaspoonful of pure honey should be taken before going to bed.
2. Sarshapa i.e. sarson powder, well mixed in a cup of milk, if taken at night before going to bed, stops the weakness of bladder.

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