Incontinence is defined as the involuntary loss of urine. Incontinence affects both men and women. A number of variables can cause incontinence. Causes of female incontinence include a “fallen” bladder (stress incontinence), bladder instability (the frequency-urgency syndrome) and neurologic causes such as strokes or multiple sclerosis. Men may experience urinary incontinence for the preceding reasons, but may also experience leakage following surgery of the prostate or after treatment for prostate cancer.
Identifying the cause of a patient’s incontinence begins with a detailed medical and surgical history. A thorough discussion of the factors which precipitate leakage is critical, and the nature of these precipitating events will provide much insight into the cause of the incontinence. Physical examinations with a detailed exam of the genitourinary system will identify many of the common causes of incontinence.
Diagnosing and Treating Incontinence
Once the cause of the incontinence has been determined, treatment recommendations can be made. Patients who leak because of bladder instability (bladder spasms) are started on medication to relax the overactive bladder muscle.
Some forms of incontinence are treated with biofeedback, or exercises to strengthen the pelvic floor muscles. More severe cases of stress incontinence require surgical intervention. A number of new surgical techniques have been developed, several of which can be done either through the vagina or through a laparoscope with a one-two day hospital stay.