Incontinence and beyond: How to avoid the social stigma- Dr Mathisekaran Thangarasu

Dr Mathisekaran Thangarasu - Consultant Urologist, Asian Institute of Nephrology and Urology, Chennai

Over active bladder and urinary incontinence is a common problem seen usually in elderly males and females. The continence mechanism is controlled by complex neurogenic pathway which in coherence with the muscle sphincters, will help us to ‘hold' or ‘let go' of urine as we desire.

When this mechanism fails, it will result in incontinence, which is usually temporary and rarely, it can be permanent. There many types of incontinence, the commonest being stress urinary incontinence, the others are urge and mixed incontinence, overflow incontinence, etc.

Stress urinary incontinence is precipitated by any act which suddenly increase abdominal pressure, like coughing, sneezing, laughing, exercise, etc. In women, this is usually post uterus removal surgery, or pelvic radiations for cancers. In men this is usually due to prostate enlargement or surgery for prostate cancer. Urge urinary incontinence is a main symptom of overactive bladder, also referred to as detrusor instability or over activity. This is usually seen in people with stroke or Parkinson's disease, Urinary tract infection etc.

These problems can be addressed by lifestyle modification such as drinking adequate amount of water, avoiding smoking, alcohol and coffee, acidic and spicy foods. There are medications to reduce and control the incontinence. Very rarely does one needs surgical corrections for controlling incontinence. With proper medical consultation and systematic investigations, we can very well control and treat this socially embarrassing condition.