In this article, we will discuss Brief Note on Incontinence. So, let’s get started.
Incontinence
It is the inability to control the passing of urine and feces so that either or both excretions are passed at inappropriate times or places.
1. Genuine stress incontinence: It is the involuntary loss of urine when pressure in the bladder exceeds maximum urethral pressure in the absence of a detrusor contraction.
2. Urge incontinence: This is the involuntary loss of urine associated with a strong desire to void. It may be divided into two types: (i) motorurge: due to uninhibited destructor contractions (ii) sensory urge: due to acute or chronic infections urinary calculi bladder tumour.
3. Neurogenic incontinence: In this the problem may be atonic or automatic bladder.
1) Atonic/autonomous/over flow incontinence: (LMN bladder) this is involuntary loss of residual urine in dribbles.
Causes: Obstruction to out flow of urine constant enlargement, pelvic tumour, urethras steroids retroverted ground uterus – diabetic neuropathy.
ii) Reflex incontinence/hypertonic/automatic bladder: It is due to abnormal reflex activity in the spinal cord in the absence of sensation.
Causes: Disorders of brain/spinal cord trauma (paraplegia).
4. Continuous incontinence: This may be due to pathological or structure abnormality or major trauma or surgery.
5. Frequency incontinence: It may be self-induced because of fear of looking – aging.
Pelvic Floor Assessment
• History
• Explanation with cupped hands(how PFM work)
• Observation (for inflammation discharge, prolapsed, etc)
• Digital clock
• Jumping with full bladder to check PFM
Exercises (PFM) (Kegel Exercise)
• Squeeze of lifts exercises (5–6 contractions)
• Contract during micturition (stop start to flow of urine)
• It is done (PFM exercise) during lying, sitting, running or jumping, laughing, skipping, standing, sneezing & lifting.
• Bladder retraining is taught (how to lengthen or delay micturition).
• Walking encouraged.
Electrotherapy
• SWD to treat PID
• IDC (interrupted direct current)
• Faradism
• Interferential therapy can be used.
For further information regarding Kegel Exercises click below: