Urge Incontinence e-chart: Full illustrated

14 Pages·2016·2.366 MB·English

by  HC-HealthComm (editor)

The First Edition of "Urge Incontinence": This chart was created by Anejo Health Communications.
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Table of Contents
Urge Incontinence
Normal Micturition
Anatomy
Pathogenic Mechanism
Motor Causes
Sensory Causes
Mixed Causes
Signs and symptoms
Diagnosis
Treatment
Complications
Urge Incontinence
Urge incontinence, unstable bladder, or overactive bladder is the loss of a large amount of urine, a
condition that can result both from physical or psychic problems.
It is more frequent in women because of the gynecological factors implied, and in the elder. Urge
incontinence occurs when the desire to urinate cannot be controlled (there is previous awareness of the
need to urinate) because of a sudden contraction of the bladder muscles hindering the performance of
the external sphincter.
Urge incontinence is more frequent in women. This is mainly due to two reasons: obstetrics, implying
women who have given birth to many children, who undergo a normal relaxation of the pelvic muscles.
Also menopause and an estrogenic deficit, causing the pelvic muscles to degenerate so that the usual
localization of the pelvic organs is lost, thus favoring incontinence.
Normal Micturition
A. When urine accumulates inside, the walls of the bladder stretch in those parts where there are
nervous receptors that respond to this type of stimulus.
B. The stimulus is transmitted to the spinal cord through a sensory and motor nerve impulse.
C. A motor impulse is sent from the brain so that the walls of the bladder contract. Urine is directed
toward the internal sphincter, which relaxes.
D. The need to urinate is detected by the brain.
E. Micturition can now take place, which implies relaxing the external sphincter.
Micturition is a reflex act controlled by the brain after a learning process. There are two sphincters
regulating the discharge of urine. One is the internal sphincter, which closes the urethra and is made up
of smooth muscle fibers; it is not voluntary. The one below, the external sphincter, is made up of skeletal
muscle fibers surrounding the urethra; it is voluntary.
Anatomy
Pathogenic Mechanism
Urge incontinence occurs when the normal micturition cycle and the relaxation process of the external
sphincter become dysfunctional. The following causes can be mentioned: Neurological Problems:
Parkinson’s disease, multiple sclerosis, cerebrovascular accident, spinal cord injury, Alzheimer’s disease,
dementia.
Infectious Diseases: urinary tract infection, vaginitis, urethritis. Renal, prostatic, or gynecological tumors.
Other Causes: diabetes mellitus, secondary effects of diuretics, post menopause (lack of estrogen
stimulation), constipation, a previous surgery of the pelvis or urinary bladder, dehydration.
The vesical muscle can be affected by, and eventually lead to, urge incontinence by means of three
mechanisms.
Motor Causes
The detrusor muscle of the urinary bladder is overactive and so leads to urinary incontinence. The
inhibition of the micturitional reflex is dysfunctional.
It is caused by psychic mechanisms, efforts, or obstructions.
Sensory Causes
There appears an early sensation of a filled bladder and an urge to urinate.
This is caused by an increase in the sensory impulses from the receptors in the walls of the urinary
bladder. It can be associated with diseases.