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Urge incontinence (UI): Urine leaking before getting to toilet

Stress incontience
FB Dr Soarawee
Soarawee Weerasopone, MD

Minimally Invasive Uro-Oncologist
Royal Phnom Penh hospital, Kingdom of Cambodia

The definition of Urge urinary incontinence is a sudden sense of urinating which is very difficult to hold it, causing some urine leaking for sometimes. The etiology of UI can be categorized for 3 major causes.

  1. Overactivity of bladder muscle – Bladder is like water-pump its function is to contract all urine out of the bladder while the urine is full. In normal condition, when the bladder is demanding to contract, so sense of urinating will make us to be at the bathroom and urinate freely. But what if you lose control of bladder and experiencing a muscle contracting suddenly and a strong urge of urinating hits? Then you may not be able to make it to the bathroom in.
  2. Poor communicable of bladder muscle – Literally, a normal bladder also acting like a balloon- resilient to store urine as much as it can, any conditions that harm or reducing the bladder-recipient’s quality, so the urine will naturally seeking its way out and basically it will get through the urethra.
  3. Hypersensitivity of bladder sensorium – Another cause of urge incontinence happens while the sensory unit of bladder mucosa responds too strong with specific stimuli. So you will experience the dribbling before you’re in the bathroom.

Urge Incontinence (UI) has been reported as the 2nd most common incontinence after the stress incontinence. It is confirmed that aging and obesity really involved with UI. Surprisingly, UI is predominant in male.

Aging
Aging is one factor involved with UI.

When patients got into my urology’s office, the full history as well as physical examination along with necessary imaging is recommended to confirm the diagnosis of UI. The American Urological guideline has been recommended the treatment options for UI into 3 different levels.

  1. Behavioral therapies
    • Train your bladder and regulated proper time for bathroom in
    • Dietary modify changes
    • Avoid the irritation to the bladder such as caffeine or smoking
    • Pelvic floor muscle training
Caffeine
Avoid caffeine can possibly improve UI.
  1. Medications
    • Antimuscarinic agents
    • Beta-3 agonists
  2. Intravesical botulinum toxin injection
    • The toxin will paralyze the bladder muscle and it works for the improvement of UI
    • If clinical improving, remains maintaining the injection for every 6 months as the requirement.
Botox
Endoscopic botox injection has a role in UI treatment.

Again, the prognosis of UI so varies among patients, that’s why Urologist must discuss with the patient in order to setting individual’s goal. If you have any questions, it is good to discuss with your very trusted urologist or it would be my honor if you text me. See you for the next content!

Urology
Urologist is a specialist who take care of UI.
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