परिभाषा
Urinary incontinence is the loss of voluntary bladder control that can lead to urine leakage. Incontinence can be temporary or long-lasting. It is a symptom, not a condition.
का कारण बनता है
The causes may vary with the type of incontinence.
तनाव में असंयम
The leakage may be caused by:
- Weakening of the muscles that suspend the bladder
- Weakening of the muscles that control urine flow
- Damage to the muscles that control urine flow following prostate surgery
- मोटापा
उत्तेजना पर असंयम
This is also known as overactive bladder. It may be caused by:
- मूत्र पथ के संक्रमण
- मधुमेह टाइप 1 और टाइप 2
- Bladder irritation (such as kidney stone or tumor)
- दवाएं (जैसे हिप्नोटिक्स या मूत्रवर्धक)
- कैफीन
- शराब
- तंत्रिका क्षति के कारण:
- रीढ़ की हड्डी में चोट
- आघात
- मल्टीपल स्क्लेरोसिस
- पार्किंसंस रोग
- कब्ज़
अतिप्रवाह असंयम
This occurs when the bladder will not empty. The urine builds up and overflows. This leads to leaking of urine. It may be caused by:
- Prostate enlargement
- Bladder that is blocked, such as by a scar in the urethra (stricture)
- Fecal impaction putting pressure on the urethra
- Drugs (such as antidepressants, hypnotics, antipsychotics, beta-blockers, antihistamines, calcium channel blockers)
- विटामिन बी12 की कमी
- कमजोर मूत्राशय की मांसपेशियाँ
- चेता को हानि
कार्यात्मक असंयम
This is when you have normal bladder control, but you are unable to reach the toilet in time. It may be a result of a condition like severe arthritis. Drugs that cause confusion or sedation can also lead to functional incontinence.
There may be several different causes for incontinence. In some cases, the cause may also be unclear.
जोखिम कारक
Factors that may increase your risk of incontinence include:
- उम्र: 65 से अधिक
- इतिहास का prostate surgery
- Prostate enlargement due to benign prostatic hyperplasia (BPH), infection, orprostate cancer
- मूत्र पथ के संक्रमण
- मोटापा
- फेफड़ों की पुरानी बीमारी
- मूत्रमार्गशोथ
- अवसाद
- Dementia (including Alzheimer’s disease)
- मधुमेह
- आघात
- मल्टीपल स्क्लेरोसिस
- रीढ़ की हड्डी में चोट या बीमारी
- कुछ पदार्थों या दवाओं का उपयोग:
- कैफीन
- शराब
- बीटा अवरोधक
- अल्फा एगोनिस्ट
- कोलीनर्जिक एजेंट
- साईक्लोफॉस्फोमाईड
लक्षण
मूत्र असंयम अन्य स्थितियों का एक लक्षण है। मूत्राशय पर नियंत्रण की किसी भी हानि को असंयम माना जा सकता है।
With stress incontinence, leakage may happen when there is extra pressure on your bladder. This can happen when you laugh, sneeze, lift heavy objects, or exercise.
With urge incontinence, you may have a loss of bladder control following a strong urge to urinate. You may not be able to hold urine long enough to make it to a toilet.
मुझे अपने डॉक्टर को कब बुलाना चाहिए?
यदि आपको मूत्र नियंत्रण में कमी महसूस हो तो अपने डॉक्टर को बुलाएँ। आपका डॉक्टर अंतर्निहित कारण निर्धारित करने में आपकी सहायता कर सकता है।
निदान
Your doctor will ask about your symptoms and medical history. You will be asked about your urine leakage and how often you empty your bladder. A physical exam will be done to look for any physical causes. These include blockages or nerve problems. Your doctor may ask you to keep a diary of your urinary habits.
You may be referred to a specialist. Urologists are doctors who focus on urinary issues.
Tests to help find the cause of the incontinence may include:
- Stress test—you relax, and then cough as your doctor watches for loss of urine (this will confirm if you have stress incontinence)
- मूत्र परीक्षण
- Tests to explore problems with your prostate (such as a prostate exam or blood tests)
- मधुमेह का पता लगाने के लिए रक्त परीक्षण
- Ultrasound—uses sound waves to examine structures inside the body to determine if any urine remains in your bladder after urinating
- सिस्टोस्कोपी - मूत्रमार्ग और मूत्राशय को देखने के लिए एक छोटे कैमरे के साथ एक पतली ट्यूब मूत्रमार्ग में डाली जाती है
- Urodynamic tests—used to measure the flow of urine and the pressure in the bladder
उपचार
उपचार में शामिल हो सकते हैं:
व्यवहार थेरेपी
व्यवहार थेरेपी में शामिल हैं:
- Making muscles stronger by doing Kegel exercises
- These strengthen the muscles that hold the bladder in place and control urine flow.
- Painless electrical stimulation is sometimes used. It can strengthen the muscles more quickly. It is helpful for stress incontinence.
- Creating a regular schedule to empty your bladder (called bladder training). This training may also involve drinking fewer liquids
वजन घटना
Losing weight may help reduce the number of episodes due to stress or urge incontinence. Talk to your doctor about a weight loss program that is right for you.
दवा
Medicines may be prescribed to relax the bladder muscles. These types of medicines are called anticholinergics. They are often used in treating urge incontinence. Examples include:
- Oxybutynin (Ditropan)
- Tolterodine (Detrol)
- Darifenacin (Enablex)
- Solifenacin (Vesicare)
- Fesoterodine (Toviaz)
उपकरण
Absorbent diapers are often used by men with incontinence.
Catheters are sometimes used to treat more severe cases. External (condom) or internal (Foley) catheters may be used.
Another option is a penile clamp. These clamps are padded and have a sleeve to absorb leakage.
घर की देखभाल
- असंयम की एक घटना के बाद खुद को धीरे से साफ करके अपनी त्वचा की देखभाल करें। त्वचा को हवा में सूखने दें।
- Make it easier to get to the bathroom. For example, rearrange furniture and remove throw rugs. Add night-lights in the hallway and in the bathroom.
- If needed, keep a bedpan or urine canister handy in your bedroom.
तंत्रिका उत्तेजना
Devices like Urgent PC and Inter-Stim may be used to stimulate the nerves. This may involve implanting a thin lead wire with a small electrode tip. This electronic stimulation therapy can be done as a series of treatments in your doctor’s office.
सर्जरी
In men, surgery may be done to relieve a physical blockage due to an enlarged prostate.
Other procedures involve surgical repair or implants into the bladder sphincter. The sphincter is the gate that allows the urine to flow through.
रोकथाम
Incontinence is really a symptom of another condition. There are several ways to prevent incontinence:
- Reduce your intake of substances that lead to incontinence. These include caffeine, alcohol, and certain drugs.
- Lose weight.
- Avoid and treat constipation.