Urinary incontinence

Urinary incontinence is any involuntary leakage of urine. Urinary incontinence the loss of bladder control is a common and often embarrassing problem. The severity of urinary incontinence ranges from occasionally leaking urine when any person coughs or sneezes to having an urge to urinate that's so sudden and strong that they don't get to a toilet in time.

The Types of Urinary Incontinence

Stress Leakage of small amounts of urine during physical movement (coughing, sneezing, exercising). Urge Leakage of large amounts of urine at unexpected times, including during sleep. Overactive Bladder Urinary frequency and urgency, with or without urge incontinence. Functional Untimely urination because of physical disability, external obstacles, or problems in thinking or communicating that prevents a person from reaching the toilet. Overflow Unexpected leakage of small amounts of urine because of a full bladder. Mixed Usually the occurrence of stress and urge incontinence together. Transient

Leakage that occurs temporarily because of a situation that will pass (infection, taking a new medication, colds with coughing). Stress Incontinence If coughing, laughing, sneezing, or other movements that put pressure on the bladder causes one to leak urine, they may have stress incontinence. Physical changes resulting from pregnancy, childbirth, and menopause often cause stress incontinence. This type of incontinence is common in women. Childbirth and other events can injure the scaffolding that helps support the bladder in women. Pelvic floor muscles, the vagina, and ligaments support the bladder. If these structures weaken, the bladder can move downward, pushing slightly out of the bottom of the pelvis toward the vagina. This prevents muscles that ordinarily force the urethra shut from squeezing as tightly as they should. As a result, urine can leak into the urethra during moments of physical stress. Stress incontinence also occurs if the squeezing muscles weaken. Stress incontinence can worsen during the week before the menstrual period. At that time, lowered estrogen levels might lead to lower muscular pressure around the urethra, increasing chances of leakage. The incidence of stress incontinence increases following menopause. Urge Incontinence If one loses urine for no apparent reason after suddenly feeling the need or urge to urinate, the person may have urge incontinence. A common cause of urge incontinence is inappropriate bladder contractions. Abnormal nerve signals might be the cause of these bladder spasms. Urge incontinence can mean that the bladder empties during sleep, after drinking a small amount of water, or when while touching water or hear it running. Certain fluids and medications such as diuretics or emotional states such as anxiety can worsen this condition. Some medical conditions, such as hyperthyroidism and uncontrolled diabetes, can also lead to or worsen urge incontinence. Involuntary actions of bladder muscles can occur because of damage to the nerves of the bladder, to the nervous system (spinal cord and brain), or to the muscles themselves. Multiple sclerosis, Parkinsons disease, Alzheimers disease, stroke, and injury including injury that occurs during surgeryall can harm bladder nerves or muscles. Overactive Bladder Overactive bladder occurs when abnormal nerves send signals to the bladder at the wrong time, causing its muscles to squeeze without warning. Voiding up to seven times a day is

normal for many women, but women with overactive bladder may find that they must urinate even more frequently. Specifically, the symptoms of overactive bladder include

urinary frequencybothersome urination eight or more times a day or two or more times at night urinary urgencythe sudden, strong need to urinate immediately urge incontinenceleakage or gushing of urine that follows a sudden, strong urge nocturiaawaking at night to urinate

Functional Incontinence People with medical problems that interfere with thinking, moving, or communicating may have trouble reaching a toilet. Functional incontinence is the result of these physical and medical conditions. Conditions such as arthritis often develop with age and account for some of the incontinence of elderly women in nursing homes. Overflow Incontinence Overflow incontinence happens when the bladder doesnt empty properly, causing it to spill over. Weak bladder muscles or a blocked urethra can cause this type of incontinence. Nerve damage from diabetes or other diseases can lead to weak bladder muscles; tumors and urinary stones can block the urethra. Overflow incontinence is rare in women. Other Types of Incontinence Stress and urge incontinence often occur together in women. This combination is termed as mixed incontinenc and it is the most common type of urine loss in women. Transient incontinence is a temporary version of incontinence. Medications, urinary tract infections, mental impairment, and restricted mobility can all trigger transient incontinence. Severe constipation can cause transient incontinence when the impacted stool pushes against the urinary tract and obstructs outflow. A cold can trigger incontinence, which resolves once the coughing spells cease. The following tests are useful to evaluate the diagnosis Bladder stress test where the patient is asked to cough vigorously as the doctor watches for loss of urine from the urinary opening. Urinalysis and urine cultureLaboratory technicians test your urine for evidence of infection, urinary stones, or other contributing causes. Ultrasoundto detect pathology of the kidneys, ureters, bladder, and urethra. Cystoscopyto detect pathology in urethra and bladder.

UrodynamicsVarious techniques measure pressure in the bladder and the flow of urine.

In Ayurvedic perspective, Urge incontinence

Vata Vrddhi Chala guna vrddhi Madhyama roga marga Vasthi sthana Suppression of urges should be avoided Kashayam Sukumara paal kashayam 60 ml in the evening Dhanwanthara paal kashayam 60 ml in the evening

Rasaushadhis Pichu Dhanwantharam tailam (A.H) Bala lakshadi Abraka senduram 50 to 100 mg twice daily with milk (Ayurveda Prakasham) Siva gulika 1/2 tablet in the morning with ghritham (A.H.) Poornachandrodayam 1 tablet twice daily after food (Basavarajiyam)

Anuvasanam Ksheerabala Dhanwantharam

Vasthi Laghu pancha moola ksheera vasti Quantity 100 ml 100 ml 100 ml 200 ml 500 ml

Dravyam Makshikam Sneham Ghrtam (Mahatiktaka ghrtam) Tailam (Bala tailam) Brhtyadi ksheera kashayam Total

Overactive bladder
Kashayam Dhnvantaram kayam 60 ml twice daily before food (A.H. Sharira sthana) Sukumra kra kayam 50 ml in the evening

Choornam Avaganddi cam 1 teaspoon with milk at night after food (Bhava Prakasha) Kapikachu choornam 1 teaspoon with milk at night after food Oridazh thamarai 1 teaspoon with milk at night after food

Tailam (internal) Krabala tailam 1 teaspoon with milk at night after food (A.H) Dhanvantaram vasthi pakam 1 teaspoon with milk at night after food Sahacharadi vasti pakam 1 teaspoon with milk at night after food

Ghritham Vatsyamayantaka 1 teaspoon bd after food (S.Y) Trikantaka ghritham 1 teaspoon bd after food (A.H. Prameha chikitsa)

Rasaushadhis Abraka senduram 50 mg twice daily after food Vasantha kusumkaram 125 to 250 mg twice daily with milk after food (Rasendra sara sangraha)

Shiro pichu Narayana tailam (Bhaishajya Ratnavali)

Thalam Nimbamrutha erandam with Rasnadi choornam

Rasayanam Brahma Rasayanam 1 teaspoon twice daily after food (Charaka Samhita)

Stress incontinence
Kashayam Vati Manasamitram 2 tablets at night after food (Sahasra Yogam) Sahacharadi 60 ml twice daily before food (A.H. Vata vyadhi) Kalyanaka 60 ml twice daily before food Sukumara 60 ml twice daily before food (A.H. Vruddhi chikitsa) Bruhatyadi 60 ml twice daily before food (Sahasra Yogam)

Rasaushadhis Abraka senduram 50 to 100 mg twice daily with milk Shilajith 1 tablet twice daily after food with milk

Avagaham Dhanwantaram kashayam Dhanyamlam

Tailam (for Pichu around umbilicus) Dhanwantram (A.H) Sahacharadi

For women yoni pichu can be done with Dhanwantharam thailam Nasyam Ksheerabala (A.H) Rasnadashamooladi tailam (A.H)

Overflow
The treatment is same as Gulma Kashayam Saptasaram 60 ml twice daily before food (Sahasra Yogam) Chiruvilwadi 60 ml twice daily before food (Sahasra Yogam) Vrthardi kayam 60 ml twice daily before food (A.H.Sutra sthanam Ganam)

Choornam Hinguvashtaka 1 teaspoon with ghritham in the afternoon with first morsel of food (Bhaishajya Ratnavali) Kalyanaka ksharam 1 gram with ghritham twice daily after food (A.H. Chikitsa sthana) Vaishvanara choornam 1 teaspoon with kashayam twice daily before food Aaviltholadi bhasmam - to be prepared in the form of gruel Induppu kaanam 3 grams with kashayam

Kulattham 3 grams twice daily after food

Vati Dhanwantharam gulika 2 tablets twice daily after food (Sahasra Yogam) Hinguvachadi pills 2 tablets twice daily after food

Anuvasanam with Dhanwantaram thailam Gomutra vasti