Diseases of the Urinogenital System - Urinary incontinence

Urinary incontinence, or the involuntary release of urine, is a highly treatable disorder of the urinogenital system. Controlled urination is a complex, synchronized process coordinated by the central nervous system involving the kidneys, the bladder, the urethra and the muscles of the pelvic floor and abdominal wall. Urine from the kidneys flows into the bladder, where it is stored until nerves in the spinal cord indicate that it is full. When this occurs, the muscles of the bladder contract in a reflex action and squeeze the urine into the urethra. In toilet training, the brain learns to control this reflex action by tightening the muscles of the pelvic wall and refusing release until an appropriate time. Disruption of nearly any part of this system can cause incontinence. Neurological problems affecting the central nervous system, infections of the genital or urinary systems, and anatomical abnormalities all can cause urinary incontinence in adults. Sometimes, though, no known cause can be discovered.

Contrary to popular myth, urinary incontinence is not the inevitable consequence of aging and is almost always treatable. A wide range of techniques including behavior modification, medication and surgery can improve or cure most cases.

Behavioral techniques, being the easiest and safest to administer, are usually tried first. These techniques involve bladder training and exercise of the pelvic muscles and bladder sphincter. Done at home, exercises such as Kegel exercises require a certain amount of practice and commitment, as it often takes several months to strengthen the relevant muscles. Medications are also available which relax the bladder or contract the muscles of the sphincter and pelvic wall. These medications can have undesirable side effects. Finally, surgery can tighten the pelvic muscles or create a vaginal “hammock” or support for the urethra to prevent it from prematurely releasing urine. A doctor should be consulted for a complete diagnosis and individualized treatment program.