Urinary incontinence

Urinary incontinence is a violation of urination, which is characterized by involuntary discharge of urine through the urethra or through a fistula that connects the urinary tract to the surface of the body. This is a symptom or symptom, not an independent diagnosis. 

Epidemiology

Epidemiological studies have established a high prevalence of urinary incontinence among the population - approximately 1%. Among patients older than 65 years, incontinence affects 10-20% of the general population. Women suffer more often than men.

[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11]

Forms

[12], [13], [14], [15], [16], [17], [18], [19], [20]

Emergency urinary incontinence

Urge incontinence is the loss of urine associated with a strong desire to empty. The causes can be: inflammatory diseases of the mucous membrane of the bladder, tumors of the bladder, stones in the intravesical part of the ureter, catheterization of the bladder.

[21], [22], [23], [24], [25], [26], [27]

Stress incontinence

Stressful urinary incontinence is the loss of urine associated with increased intra-abdominal pressure in the absence of contraction of muscle that ejects urine. Causes: insufficient resistance of the urethra and pelvic floor muscles during the passage of urine during physical activity (running, walking, climbing stairs, coughing, sneezing, etc.) is more common in women giving birth in the postmenopausal period, flight in men after surgery for hypertrophy or carcinoma prostate cancer.

Urinary incontinence with bladder overflow

Urinary incontinence with a bladder overflow is a loss of urine when the bladder is full and urine follows frequent small portions.

Causes:

1. urological diseases;
2. neurological -  polyneuropathy, mainly affecting vegetative fibers (diabetic, with primary amyloidosis, paraproteinemia), acute and subacute vegetative neuropathies, Shay-Drageer syndrome, destruction of the sacral parasympathetic center of the bladder (trauma, swelling,  multiple sclerosis, disc herniation, ischemia, sometimes lumbar -release syringomyelia), while the important diagnostic symptoms are a decrease in the tone of the external anal sphincter, the absence of bulbocavernous and anal reflexes, menstruation and hypoesthesia in the anogenital zone, stool incontinence, impotence in men; defeat of the horse's tail caused by a tumor (lipoma, neurinoma, epindimoma, dermoid), median hernia of the lumbar disc; Multiple and diffuse lesions of the pelvic nerves, observed with retroperitoneal extensions of tumors (rectal carcinoma, prostate carcinoma and genital organs in women), after extensive surgical operations in the pelvic cavity; dorsal;
3. psychogenic causes.

True incontinence

True urinary incontinence is practically a permanent loss of urine with the accumulation of a small amount in the bladder or without accumulation. The causes of true urinary incontinence are essentially the same as the causes of incontinence in case of overflow in cases when it comes to neurological causes. The phenomenon of incontinence in overfilling is associated with maintaining the elasticity of the neck of the bladder, which exerts resistance to the pressure of urine, which delays its release. In these cases, the bubble is full, stretched and the urine is released by drop, mechanically stretching the neck. With true incontinence, urine is excreted continuously by drop as it enters the bladder, not accumulating in it.

Reflex incontinence

Reflexive urinary incontinence is the loss of urine associated with abnormal reflex activity, manifested by the absence of the usual feeling of needing to empty. There is no regulation of the act of urination, an automatic, reflex type of bladder emptying is established due to the independent activity of the spinal centers. This type of urination disorder is observed with multiple sclerosis, spinal cord injury above the cone level, cervical and thoracic spine tumors, in children up to a certain age, with malignant anemia.

Extrauregetal incontinence

Extra-urethral urinary incontinence is the loss of urine through an abnormal urinary canal communication with the body surface. It occurs with urological pathology.

[28], [29], [30], [31], [32], [33], [34], [35]

Complications and consequences

Urinary incontinence can become a serious psychological problem for both the patient himself and his family members. About 70% of such patients can not find a job.

[36], [37], [38], [39], [40], [41], [42]