Question

You have a fellow student with a history of stress incontinence. While sitting in the classroom someone states a funny joke and they start laughing so hard they “pee their pants”? What should be done to help this student? What is stress incontinence, the symptoms associated with it and who is at risk for having it? How do we treat this disorder?

Answer 1

Stress incontinence

Physical movement or activity like coughing, sneezing, laughing, running or other things put pressure on bladder causing leak of urine. This is most common type of bladder control problem in women

Symptoms

If you have stress incontinence you may leak urine when you,

•Cough or sneeze

•Laugh

•Bend over

•Lift some thing heavy

•Exercise

•Have sex

Those who are having at risk of stress incontinence

•Aged

•Gender : Woman are more likely to have

•Obesity

•Exessive caffeine and alcoholic user

•Smoking due to chronic cough

•Hormonal deficiency

•Men who undergone surgery for prostate cancer

•Women who have had a vaginal delivery

Treatment

Behaviour therapies

•Pelvic floor muscle exercise

•Healthy life style changes : Quitting smoking, losing excess weight

•Bladder training : Your doctor might recommend a schedule for toileting if you have mixed incontinence. More frequent voiding of the bladder may reduce the number or severity of urge incontinence episodes

Medication

There are no approved medications to specifically treat stress incontinence. The antidepressant duloxetine (Cymbalta, Drizalma Sprinkle) is used for the treatment of stress incontinencem

Symptoms quickly return when the drug is stopped

Devices

Vaginal pessar : A specialized urinary incontinence pessary, shaped like a ring with two bumps that sit on each side of the urethra, is fitted and put into place by your doctor or nurse. It helps support your bladder base to prevent urine leakage during activity, especially if your bladder has dropped

Urethral inserts : This small tampon-like disposable device inserted into the urethra acts as a barrier to prevent leakage. It's usually used to prevent incontinence during a specific activity, but it may be worn throughout the day.

Urethral inserts can be worn for up to eight hours a day.

Surgery

Sling procedure : This is the most common procedure performed in women with stress urinary incontinence. In this procedure, the surgeon uses the person's own tissue, synthetic material (mesh), or animal or donor tissue to create a sling or hammock that supports the urethra.

Injectable bulking agents : Synthetic polysaccharides or gels may be injected into tissues around the upper portion of the urethra. These materials bulk up the area around the urethra, improving the closing ability of the sphincter.

Inflatable artificial sphincter : This surgically implanted device is used to treat men. A cuff, which fits around the upper portion of the urethra, replaces the function of the sphincter.