Prof. Rosita Aniulienė

The normal physiological filling to go to urinate is when in the urine bladder is about 250 ml of urine.

FEMALE URINARY INCONTINENCE –

is a involuntary loss of urine which is objectively demonstrable and a social or hygienic problem. WHO on June 1998 gave data that today more than 200 million people are affected by bladder control problems, incontinence has become an important public health issue. So many people suffer too often in silence – from the life – disrupting consequences of incontinece.

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FACTS ABOUT FEMALE URINARY INCONTINENCE

Incontinence can be classified under the following types according to the clinical signs:

1) Urge incontinece: occurs when patients sense the urge to void (urgency) but are unable to inhibit the leakage long enough to reach the toilet. It is most common in elderly people and could be associated with detrusor hyperactivity (motor urge) or hypersensitivity (sensory urge).

Types of Incontinece

2) Stress incontinence: an involuntary loss of urine during a physical effort or sudden movement (such as coughing, laughing etc.) due to an increased intra-abdominal pressure. May have many causes, including a direct damage of the urethral spincter and weakening of the bladder neck supports.

3) Reflex incontinence: this is due to abnormal activity of the spinal urinary reflex in cases where the urination “loops” are not functioning correctly.

4) Overflow incontinence:Is associated with urinary retention. The bladder is full “to the brim” and the urine owerflows, as a result of some obstruction which prevents the normal flow of urine. In addition the muscles of the bladder lose their ability to contract as a result of being dilated for so long. The most characteristic example of this type of incontinence is found in cases of advanced adenoma of the prostate.

5) Total incontinence: cases where the urine drops out continuously. In some cases the patient is conscious of this or her incontinence but cannot do anything to avoid it and has to face the social problems that ensue. In other cases the patient is not aware of the problem, as, for example, in disorders of the central nervous system, such as after cerebrovascular accident.

6) Post-urination incontinence: this is when the patient is unable to avoid continuing to emit drops of urine after urinating. It is exclusively a male problem: in young man the cause is the failure of the spongy bulbar muscle to close off the urethra upon completion of urination; in older man the cause is an obstruction (large prostate) which prevents the urine from returning to the bladder upon completion of urination.

7) Enuresis: this is day and night incontinence and is dealt with a later section.

8) Neurogenes incontinence – loss of urine after stroke or spinal traume or sclerosis disseminata or Parcinsonismus.