urinary incontinence

types of Incontinence

1)stress I:
- Sphincter instability due to pelvic floor injury(egrolonged pregnancy, twin pregnancy)
-symptoms: increased abdominal pressure causes urine leaks
-treatment:Surgery 1)ventral suspension= Burch or Stamey or 2)anterior vaginal repair

2)Urge Incontinence:
- Detrusor instability
-symptoms: early voiding, urgency, frequency (can be assoc with recurrent UTI)
-treatment: 1)anti-UTI 2)vaginal estrogens 3)anti-cholinergics

3)Neuropathic bladder
-Head injury, spinal injury, peripheral nerve injury
-symtoms: distended bladder, increased residual volume
-treatment: catheter: indwelling, intermittent

4) Anatomical
- vasicovaginal fistula
-leaks and infections
-Surgical repair, Pessaries in surgically unfit patients with procidentia(3 degree prolapse)