Stress Incontinence in Males

  • February 15, 2019

It is condition of unintentional loss of urine. It is not a disease, but rather a symptom of another condition. This underlying medical issue causes a loss of bladder control.

TYPES:

  1. Stress Incontinence – Involuntary loss of urine during actions such as coughing, sneezing and lifting that put abdominal pressure on bladder.
  2. Urge Incontinence – Involuntary loss of urine following an over helming urge to urinate that cannot e halted.
  3. Overflow Incontinence – Constant dribbling of urine usually associated with urinating frequently and in small amounts.
  4. Functional Incontinence – A physical or mental impairment keeps you from making it to the toilet in time.
  5. Transient Incontinence –It is often result of short term conditions such as UTI. It may also occur due to side effects of medications /other medical conditions.
  6. Mixed Incontinence – Incontinence that falls into a two or more of above categories.

CAUSES:

  • Chronic Cough
  • Constipation
  • Obesity
  • Urinary tract Infections
  • Obstruction in Urinary tract infections
  • Loss of Sphincter Strength
  • Diabetes for many years
  • Overactive bladder
  • Heart and BP Medications,
  • Sedatives and relaxants
  • Caffeine
  • Alcohol
  • Stroke and other neurological conditions

COMPLICATIONS:

  • Skin Problems – Rashes , Infections and Sores
  • Urinary tract Infections
  • Impacts on personal life

DIAGNOSIS:

  • Urine analysis
  • Bladder diary
  • Post void residual measurement
  • Urodynamic testing
  • Pelvic ultrasonography
  • Digital rectal exam
  • Physical examination
  • EEG and EMG

PREVENTION:

  • Maintain healthy weight
  • Practise Pelvic floor Exercises
  • Avoid bladder irritants –Caffeine , alcohol , acidic foods
  • Eat more fibre content food which prevents constipation and avoid urinary incontinence
  • Avoid Smoking

MANAGEMENT:

  • Medical
  • Interventional therapy
  • Physical therapy
  • Surgical

Medical treatment –

  • Alpha blockers
  • Anticholinergics
  • Antispasmodics

Interventional therapy –

  • Bulking material injection
  • Botulinum toxin type-A
  • Nerve Stimulators

PHYSICAL THERAPY:

  • Behaviour therapy :-
  • Bladder training
  • Double voiding and other progressive exercises
  • Modalities:
  • Heat
  • Cold
  • EMG Biofeedback
  • Electrical stimulation
  • Dry needling
  • Ultrasound
  • Manual physiotherapy procedures
  • Soft tissue mobilization
  • Pelvic floor strengthening exercises
  • Kegel’s Exercises
  • Manual and few other facilitative exercises

SURGICAL TREATMENT:

  • Artificial urinary sphincter (AVS) balloon
  • Sling procedure
  • Catheter
  • Urinary collection system
  • Underwear guards
  • Urinary diversion
  • Prolapse surgery

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