Urinary (Bladder) & Stool (Bowel) Incontinence
Incontinence is the inability to control bladder or bowels. Involuntary urination is referred to as urinary incontinence while involuntary soiling is referred to bowel or faecal incontinence.
Urinary Incontinence/Bladder Incontinence
A fairly common medical condition, urinary incontinence is caused by either underdeveloped bladder muscles or over active bladder muscles.
With underdeveloped muscles, patients experience urine leaking during activities such as coughing, laughing or lifting heavy objects.
When the muscles are over active, leakage of urine occurs as the patient feels the urge to pass urine even with the slightest amount of urine in the bladder.
There are other forms of incontinence, but these are the most common ones. Urinary incontinence in women is more likely than men.
Childbirth, obesity and advancing age are some of the reasons that cause urinary incontinence.
Treatment of Bladder Incontinence:
While a number of treatment for bladder incontinence are available today, more often than not, lifestyle changes such as losing weight and pelvic floor exercises that strengthen bladder muscles can bring about a major improvement. For more severe cases, urinary incontinence treatment may be surgery.
Bowel Incontinence/Stool Incontinence
Bowel incontinence occurs when a person is unable to control passing of stools.
There are various forms of continence – some face the problem of being unable to reach toilet in time (urge incontinence), while others have no awareness of rectum sensation (passive incontinence). Some experience soiling during passing wind. The frequency differs person to person.
Weakened or damaged anal muscles are often the cause of bowel incontinence. Damage to nerves can also result in incontinence.
- Constipation and diarrhoea are among the major underlying reasons as they weaken the anal muscles.
- Other reasons include injury to anal muscles & nerves of anal muscles during childbirth, aging, diseases like diabetes that lead to nerve damage, and ano rectal operation or injury involving anal area.
Non-Surgical Treatment of Incontinence
Treatment for incontinence depends on the type and severity.
Non-surgical options are used to address some of the fundamental issues.
Lifestyle and dietary modifications such as increasing water intake, adding fibre in the diet and regular exercise help in easing constipation or diarrhoea.
Pelvic floor exercises are used to strengthen the muscles which control bowel movements. In addition to the exercises, bowel re-training and biofeedback can also lead to improving the control over bowel movements.
However, if these measures do not result in any improvement, surgery might be advisable.
Surgical Options for Treating Incontinence
Surgery for incontinence repairs or replaces the sphincter muscles which are the most important muscles for maintaining bowel control.
In sphincteroplasty, damaged sphincter muscles are repaired by overlapping muscles and sewing them, making them stronger.
Sacral and tibial nerve stimulation help improve the functioning of weakened sphincter muscles by generating electricity pulses. Other methods include injecting bulking agents like collagen or silicone to strengthen the muscles and applying heat to scar tissues and tighten the muscles.
Artificial anal sphincter is the preferred treatment when there is permanent damage to sphincter muscles and they cannot be repaired in any way. In this treatment, a plastic cuff, which mimics the anal sphincter in its working, is implanted in the anus. The cuff is operated by a pump which opens and closes it as required.
As a form of treatment, artificial anal sphincter implantation is relatively new but it has been recognised as one of most effective treatments available today.