Urge incontinence
Encyclopedia
Urge incontinence is a form of urinary incontinence
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Urge incontinence is involuntary loss of urine occurring for no apparent reason while feeling urinary urgency
, a sudden need or urge to urinate.
Idiopathic Detrusor Overactivity – Local or surrounding infection, inflammation or irritation of the bladder.
Neurogenic Detrusor Overactivity
– Defective CNS inhibitory response.
Patients with urge incontinence can suffer incontinence during sleep, after drinking a small amount of water, or when they touch water or hear it running (as when washing dishes or hearing someone else taking a shower).
Involuntary actions of bladder muscles can occur because of damage to the nerves of the bladder, to the nervous system (spinal cord and brain), or to the muscles themselves. Multiple sclerosis, Parkinson's disease, Alzheimer's Disease, stroke, spina bifida
and injury—including injury that occurs during surgery—can all harm bladder nerves or muscles.
and learning how to cope with urges to urinate.
Fluid management is the cornerstone of all urinary incontinence. Techniques include not drinking lots of fluids and avoiding certain foods and beverages which stimulate or irritate the bladder, for example alcohol, caffeine and acidic foods.
Urinary incontinence
Urinary incontinence is any involuntary leakage of urine. It is a common and distressing problem, which may have a profound impact on quality of life. Urinary incontinence almost always results from an underlying treatable medical condition but is under-reported to medical practitioners...
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Urge incontinence is involuntary loss of urine occurring for no apparent reason while feeling urinary urgency
Urinary urgency
Urinary urgency is a sudden, compelling urge to urinate. It is often, though not necessarily, associated with urinary incontinence, polyuria, nocturia, and interstitial cystitis. It tends to increase with age...
, a sudden need or urge to urinate.
Causes
The most common cause of urge incontinence is involuntary and inappropriate detrusor muscle contractions.Idiopathic Detrusor Overactivity – Local or surrounding infection, inflammation or irritation of the bladder.
Neurogenic Detrusor Overactivity
Bladder sphincter dyssynergia
Bladder sphincter dyssynergia is a consequence of a neurological pathology such as spinal injury or multiple sclerosis that disrupts central nervous system regulation of the micturition reflex resulting in dyscoordination of...
– Defective CNS inhibitory response.
Presentation and pathophysiology
Medical professionals describe such a bladder as "unstable", "spastic", or "overactive". Urge incontinence may also be called "reflex incontinence" if it results from overactive nerves controlling the bladder.Patients with urge incontinence can suffer incontinence during sleep, after drinking a small amount of water, or when they touch water or hear it running (as when washing dishes or hearing someone else taking a shower).
Involuntary actions of bladder muscles can occur because of damage to the nerves of the bladder, to the nervous system (spinal cord and brain), or to the muscles themselves. Multiple sclerosis, Parkinson's disease, Alzheimer's Disease, stroke, spina bifida
Spina bifida
Spina bifida is a developmental congenital disorder caused by the incomplete closing of the embryonic neural tube. Some vertebrae overlying the spinal cord are not fully formed and remain unfused and open. If the opening is large enough, this allows a portion of the spinal cord to protrude through...
and injury—including injury that occurs during surgery—can all harm bladder nerves or muscles.
Timed voiding or bladder training
Timed voiding (urinating) and bladder training are techniques that use biofeedback. In timed voiding, the patient fills in a chart of voiding and leaking. From the patterns that appear in the chart, the patient can plan to empty his or her bladder before he or she would otherwise leak. Biofeedback and muscle conditioning—known as bladder training—can alter the bladder's schedule for storing and emptying urine.Surgery
Urodynamic testing seems to confirm that surgical restoration of vault prolapse can cure motor urge incontinence.Behavior
Behavior techniques for incontinence include retraining the bladder to hold more urine. The goal is to lengthen the time between periods of urination. This includes relaxation techniquesRelaxation technique
A relaxation technique is any method, process, procedure, or activity that helps a person to relax; to attain a state of increased calmness; or otherwise reduce levels of anxiety, stress or anger...
and learning how to cope with urges to urinate.
Fluid management is the cornerstone of all urinary incontinence. Techniques include not drinking lots of fluids and avoiding certain foods and beverages which stimulate or irritate the bladder, for example alcohol, caffeine and acidic foods.
Medications
- OxybutyninOxybutyninOxybutynin is an anticholinergic medication used to relieve urinary and bladder difficulties, including frequent urination and inability to control urination , by decreasing muscle spasms of the bladder. It competitively antagonizes the M1, M2, and M3 subtypes of the muscarinic acetylcholine...
, TolterodineTolterodineTolterodine is an antimuscarinic drug that is used to treat urinary incontinence.It is marketed by Pfizer in Canada and the United States by its brand name Detrol. In Egypt it is also found under the trade names Tolterodine by Sabaa and Incont L.A...
, DarifenacinDarifenacinDarifenacin is a medication used to treat urinary incontinence. It used to be marketed by Novartis; however in 2010 US rights for were sold to Warner Chilcott for 400 million US$....
, Topical vaginal estrogen, Tricyclic antidepressants