The patient complains that he has lost the power of controlling the flow of urine and the clothes get soaked with it. The condition is INCONTINENCE OF URINE.

Incontinence of urine may be true or false incontinence . true incontinence occurs when urine dribbles away involuntarily, as fast as it is formed. That means the bladder fails to retain the urine either temporarily or permanently. It is common in old place when they are bedridden during acute liine3sses or suffer from cerebral arteriosclerosis. False incontinence is due to overflow from an over distended bladder during retention or urine.

Symptoms

Many people experience occasional, minor leaks of urine. Others may lose small to moderate amounts of urine more frequently.

Types of urinary incontinence include:

• Stress incontinence. Urine leaks when you exert pressure on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy.
• Urge incontinence. You have a sudden, intense urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night. Urge incontinence may be caused by a minor condition, such as infection, or a more-severe condition such as a neurologic disorder or diabetes.
• Overflow incontinence. You experience frequent or constant dribbling of urine due to a bladder that doesn't empty completely.
• Functional incontinence. A physical or mental impairment keeps you from making it to the toilet in time. For example, if you have severe arthritis, you may not be able to unbutton your pants quickly enough.
• Mixed incontinence. You experience more than one type of urinary incontinence.

Causes

Urinary incontinence isn't a disease, it's a symptom. It can be caused by everyday habits, underlying medical conditions or physical problems. 

Temporary urinary incontinence

Certain drinks, foods and medications may act as diuretics — stimulating your bladder and increasing your volume of urine. They include:

• Alcohol
• Caffeine
• Carbonated drinks and sparkling water
• Artificial sweeteners
• Chocolate
• Chili peppers
• Foods that are high in spice, sugar or acid, especially citrus fruits
• Heart and blood pressure medications, sedatives, and muscle relaxants
• Large doses of vitamin C

Urinary incontinence may also be caused by an easily treatable medical condition, such as:

• Urinary tract infection. Infections can irritate your bladder, causing you to have strong urges to urinate, and sometimes incontinence.
• Constipation. The rectum is located near the bladder and shares many of the same nerves. Hard, compacted stool in your rectum causes these nerves to be overactive and increase urinary frequency.

Persistent urinary incontinence

Urinary incontinence can also be a persistent condition caused by underlying physical problems or changes, including:

• Pregnancy. Hormonal changes and the increased weight of the fetus can lead to stress incontinence.
• Childbirth. Vaginal delivery can weaken muscles needed for bladder control and also damage bladder nerves and supportive tissue, leading to a dropped (prolapsed) pelvic floor. With prolapse, the bladder, uterus, rectum or small intestine can get pushed down from the usual position and protrude into the vagina. Such protrusions can be associated with incontinence.
• Changes with age. Aging of the bladder muscle can decrease the bladder's capacity to store urine. Also, involuntary bladder contractions become more frequent as you get older.
• Menopause. After menopause women produce less estrogen, a hormone that helps keep the lining of the bladder and urethra healthy. Deterioration of these tissues can aggravate incontinence.
• Hysterectomy. In women, the bladder and uterus are supported by many of the same muscles and ligaments. Any surgery that involves a woman's reproductive system, including removal of the uterus, may damage the supporting pelvic floor muscles, which can lead to incontinence.
• Enlarged prostate. Especially in older men, incontinence often stems from enlargement of the prostate gland, a condition known as benign prostatic hyperplasia.
• Prostate cancer. In men, stress incontinence or urge incontinence can be associated with untreated prostate cancer. But more often, incontinence is a side effect of treatments for prostate cancer.
• Obstruction. A tumor anywhere along your urinary tract can block the normal flow of urine, leading to overflow incontinence. Urinary stones — hard, stone-like masses that form in the bladder — sometimes cause urine leakage.
• Neurological disorders. Multiple sclerosis, Parkinson's disease, a stroke, a brain tumor or a spinal injury can interfere with nerve signals involved in bladder control, causing urinary incontinence.

Risk factors

Factors that increase your risk of developing urinary incontinence include:

• Gender. Women are more likely to have stress incontinence. Pregnancy, childbirth, menopause and normal female anatomy account for this difference. However, men with prostate gland problems are at increased risk of urge and overflow incontinence.
• Age.  the muscles of bladder and urethra lose some of their strength. Changes with age reduce how much  bladder can hold and increase the chances of involuntary urine release.
• Being overweight. Extra weight increases pressure on  bladder and surrounding muscles, which weakens them and allows urine to leak out when  cough or sneeze.
• Smoking. Tobacco use may increase your risk of urinary incontinence.
• Family history. If a close family member has urinary incontinence, especially urge incontinence, your risk of developing the condition is higher.
• Other diseases. Neurological disease or diabetes may increase risk of incontinence.

Complications

Complications of chronic urinary incontinence include:

• Skin problems. Rashes, skin infections and sores can develop from constantly wet skin.
• Urinary tract infections. Incontinence increases risk of repeated urinary tract infections.
• Impacts on your personal life. Urinary incontinence can affect our social, work and personal relationships.

Prevention

Urinary incontinence isn't always preventable. However, to help decrease your risk:

• Maintain a healthy weight
• Practice pelvic floor exercises
• Avoid bladder irritants, such as caffeine, alcohol and acidic foods
• Eat more fiber, which can prevent constipation, a cause of urinary incontinence
• Don't smoke, or seek help to quit smoking

HOMOEOPATHIC TREATMENT

It is very necessary to treat true incontinence, otherwise bed sores will develop soon. To avoids this, a bed pan should be used two hourly, and any infection of the bladder  needs to be treated. The patient should be rolled from side to side to avoid stagnation. In elderly males, a condom catheter can be used with a bag to avoid any soiling of clothes. Adult pampers are now available and may be used by elderly patients.

Causticum -Useful in senile persons. Bathing in rivers in summer result in paralysis of the bladder leading to incontinence from long retention of urine. Incontinence also results during first sleep and from slightest excitement. Involuntary urination on increased intra-abdominal poressure as from sneezing and coughing urine dribbles or passes slowly. Passes urine better while sitting. Insensible urethra while passing urine.

Arnica Montana- the bladder feels sore and full, pressure of urine hurts. Involuntary dribbling with constant urging. Patient has to wait for a long time to pass urine. Retention of urine after over exertion, after labour.

Apis mellifica has incontinence of urine at night. Patient cannot urinate without a stool. Dysuria with stinging pain. Last drop stings and burns, frequent and involuntary. An increased flow of urine shows that the drug is having a favorable effect.

Staphysagria -Usefull for honeymoon cystitis; irritable bladder in young, married women; ineffectual urge to pass urine in newly married woman. Constant pressure on the bladder as if the bladder did not empty. Frequent urge to urinate with scanty urination. Sensation as if a drop of urine is constantly rolling along the urethra.

RL25

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