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Urinary incontinence or involuntary leakage of urine is socially, emotionally and psychologically disturbing! And unfortunately much more common in women!
This Women’s Day I would like to dedicate this topic to all the Women.

Q. What is urinary incontinence?
A. Inability to control the act of urination with involuntary leakage is called incontinence.

Q. What are the types of incontinence?
A. 1. Urge incontinence: leakage of urine preceded by a sudden strong urge to urinate which is difficult to control.
2. Stress Incontinence: leakage of urine which happens on straining acts like coughing, sneezing, laughing or running.
3. Continuous incontinence: Continuous leakage of urine through the urine passage or through vagina due to abnormal communication between urinary tract and vagina(usually after a complicated labor or complicated pelvic surgery) or due to some congenital anamolies.

Q. Why is incontinence a problem?
A. 1. Social embarrassment: many women avoid socializing or restrict their activities out of fear to wet their clothes in public.
2. Hygiene issues: prolonged moisture exposed genital skin can lead to skin issues like maceration, fungal infections or odor issues. Many women need to wear pads throughout the day.

Q. Why do women do not seek treatment for this issue?
A. Many women consider it as a normal part of ageing or child bearing and continue to suffer it unfortunately. Many women are not aware that it can be easily corrected if help is sought.

Q. Why does it happen?
A. 1. Hypersensitive or Overactive bladder: urinary bladder is supposed to store urine till the time it can be socially possible to empty the bladder. However a bladder whose capacity is reduced due to reasons like infection, oversensitivity of muscle of bladder, stone in bladder, radiation can lead to difficulty in control urine causing urge incontinence.
2. Stress incontinence can happen due to weakening of pelvic floor muscles or sphincters (mechanisms which control urine outlet) due to childbearing or neurological problems like spine issues, Diabetes, Stroke etc.
3. Continuous incontinence can happen due to abnormal communication between urinary tract and vagina(Vesico Vaginal Fistula). The leakage of urine happens through vagina in this case. Causes are a complicated labor or surgery like caesarian, hysterectomy (removal of uterus).

Q. Is urinary incontinence curable?
A. Urinary incontinence is completely curable. Unfortunately most of the Women don’t seek help either out of ignorance or fear!

Q. How is incontinence treated?
A. 1. Simple measures like AVOIDING excess fluid intake, reducing intake of tea or coffee can reduce incontinence in majority of women. Unfortunately I found out in my practice that many women just do the opposite!! They believe that leakage is because of a urinary infection and taking more water will clear it. Taking excess fluid will only aggravate it.
2. Pelvic floor exercises like Kegel’s exercises strengthen the muscles which control the urine. However the effects are noticed only after a few months so patience is required.
3. There are medicines(anticholinergics) available and can be prescribed by your urologist after assessment. These medicines can treat most cases of urge incontinence.
4. The rare cases of urge incontinence which do not respond to medicines can be treated by injections of Botox in the urinary bladder under guidance of cystoscope(looking inside urine bladder by a camera). It is a simple procedure performed by a urologist.
5. The severe cases of stress incontinence which don’t respond to simple measures can be effectively treated by a daycare procedure called as Sling Procedure which tightens and reinforces the weak sphincters of bladder outlet.
6. Treatment of underlying factors like diabetes, urinary infection, change of some blood pressure medicines known to aggravate incontinence like diuretics, can cure incontinence.

Q. Why should women not ignore urinary incontinence?
A. Not only it is a social issue but sometimes it may be because of an underlying serious disease like a bladder cancer or a tumor of the pelvic area pressing on the bladder. So one must never ignore the symptoms

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