Incontinence
Stress incontinence: Stress incontinence is the leakage of urine during exercise, coughing, sneezing, laughing, walking, lifting heavy objects such as lifting a bag of groceries, rising from a sitting to a standing position, or other body movements that put pressure on the bladder. The word 'stress' in this case does not mean emotional stress. The stress referred to here is physical in nature. It refers to an increased pressure on the bladder when ordinary physical activities are performed. The time period during which leakage occurs may be very short. This type of incontinence may be due to poor bladder support or a weak/damaged sphincter. It is the most common type of incontinence and can almost always be cured.

Most women with stress urinary incontinence have weak pelvic muscles. These are the muscles that support the bladder, bladder neck and the urethra (the urinary passage). Pregnancy, childbirth and prior pelvic surgery are among the reasons for weakened pelvic muscles.

Another possible cause for stress incontinence in women is a weakened urethral sphincter muscle itself. Both of these, weak pelvic muscles and a weakened urethral sphincter muscle, may co-exist in the same patient.

Urge Incontinence: Urge incontinence is the inability to hold urine long enough to reach a toilet. In this type of incontinence, an overactive bladder contracts without you wanting it to do so. You may feel as if you can't wait to reach a toilet. There is the sudden strong urge to urinate, with an uncontrollable rush of urine. It is often found in people who have conditions such as diabetes, stroke, dementia, Parkinson's disease and multiple sclerosis. It can also be a warning sign of early bladder cancer. In men, it is often a sign of an enlarged prostate. It can, however, occur in otherwise healthy, older people.

Overflow Incontinence: Overflow incontinence is the leakage of small amounts of urine from a bladder that is always full. It results when the bladder is allowed to become so full that it overflows.In this form of incontinence, the bladder never completely empties, and the urine stream is weak, with a frequent or constant dribble. Overflow incontinence can occur when the flow of urine from the bladder is blocked as in the case of a blocked urethra, when there is loss of normal bladder function in some people with diabetes, or due to bladder muscle weakness.

Functional Incontinence: Functional incontinence occurs in many older people who have normal urine control but who have difficulty reaching a toilet in time because of arthritis or other crippling disorders.

Total Incontinence: Total incontinence occurs when there is a complete loss of bladder control, usually occurring after some form of surgery to the lower urinary tract.

Mixed Incontinence: is a combination of urge and stress incontinence.

Uroflowmetry (Urine Flow Test): Uroflowmetry (urine flow test) is the simplest of the urodynamic tests. [Urodynamics are special outpatient tests used to assess the normal and abnormal function of the urinary tract, especially the bladder and the urethra (the 'water-pipe' leading from the bladder to the outside of the body). These range from the simple to the more sophisticated depending upon the complexity of your problem].

This test measures the rate of urine flow as well as the amount of urine passed. You will have to come to the clinic with a reasonably full bladder (as per what feels comfortable to you), sit on a modified toilet seat (called a micturition chair) and, in private, pass urine in the usual way, into a flow meter.
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