URINE INCONTINENCE
It is defined as involuntarily leakage of urine. It may occur in patients with a normal urinary tract, as the result of dementia or poor mobility or transiently during acute illness or hospitalization, especially in older people.
CAUSES:
- Female more than male
- Child birth
- Hysterectomy
- Obesity
- Recurrent UTI
- Smoking
- Caffeine
- Spinal injury
- Constipation
- Idiopathic
- Atony of urinary bladder
SIGN AND SYMPTOMS
- Patient should be encouraged to keep a voiding diary, including the measured volume voided, frequency of voiding, a note of incontinence pad usage, precipitating factors and associated feature such as urgency, since this can be diagnostic value.
- The patient should be assessed for evidence of cognitive impairment and impaired mobility.
- A neurological assessment should be performed to detect disorders such as multiple sclerosis that may affect the nervous supply of the bladder.
- Lumbar spine should be inspected for features of spinal bifida occulta.
- Perineal sensation and anal sphincter tone should be assessed.
- Rectal examination need to assess for prostate in men and exclude faecal impaction as a cause
- Genital assessment should be performed to identify phimosis or paraphimosis in men and vaginal mucosal atrophy, cystocels or rectoceles in women.
DIAGNOSIS
- Urinalysis and culture in all patient.
- USG will help for flow and incomplete bladder emptying.
- Cystometrography
- CT scan and cystoscopy should be perform in suspecting of fistula.
- MRI in urethral diverticulum suspecting.
