What is Urinary Incontinence?

Urinary Incontinence (UI) is a condition that affects millions of people worldwide. UI is the loss of bladder control which is caused by multiple factors. It is a common and often embarrassing problem. The exact proportion of people that experience this condition varies depending on the source, but it is estimated that at least 10% of the population experiences some form of Urinary Incontinence during their lives. Typically, the proportion of women is significantly more than that of men by about 8-10 times. UI has a major impact in long-term care facilities. It is the second-leading reason for placement of older adults in institutionalized care.

Despite the prevalence and effect of UI, many people are reluctant to talk openly about it or to seek treatment. UI is common and its severity ranges from occasional leak episodes upon coughing or sneezing to lack of control and ability to reach a bathroom.

The process of urinary control is complex involving biological, somatic, and habits related to medicine and food intake. Biologically, the bladder mechanism is a combination of synchronous activities of various muscles as well as sensory and motor functions.

Under normal clinical conditions, the Detrusor (muscle surrounding the bladder wall) and the Urethral Sphincters (muscles controlling the closure of the Urethra) are coordinated by the nervous system in a manner as to ensure proper voiding of the bladder. If electrical activity of the Detrusor causes it to contract before the Sphincters relax, the result will be improper emptying of the Bladder.

There are multiple types of UI. The first categories relate to the function of the Detrusor, the Urethral Sphincters and the Pelvic Floor and they include:

Urge Urinary Incontinence

Also known as “overactive bladder (OAB)”; “detrusor instability”; “phasic detrusor hyperreflexia”; “irritable bladder”; "Hyperactive bladder"; “spasmodic bladder”; “idiopathic urge incontinence”; “idiopathic detrusor overactivity” (IDO) and “unstable bladder”.

It is urine leakage caused by a sudden inappropriate contraction of the "detrusor" muscle (the detrusor is the muscle that “squeezes” the bladder to force urine out). Typical bladder function is characterized by an automatic/involuntary relaxation of the sphincter whenever the detrusor contracts strongly enough.

Normally, the Detrusor muscle will not contract strongly enough unless the bladder becomes very full (which is when we all have a feeling that we can't “hold it in” anymore). The fuller the bladder, the stronger the contraction until urine is expelled from the bladder (with or without our control).

This is exactly what happens with urge urinary incontinence except that the detrusor muscle frequently contracts strongly when the bladder is not full. This means that the patient may at any time suddenly have a feeling of needing to get to a bathroom fast, and regardless of the amount of urine inside the bladder, it can be expelled involuntarily.

These inappropriate bladder contractions may be caused by misfiring nerves (neurological) or some intrinsic defect with the muscle that causes it to "squeeze" even if the bladder is not full. For this reason UI is also known as "overactive bladder" because the bladder contracts frequently and randomly, irrespective of bladder fullness.

The cause of the unwanted contractions is often unknown, at which point it is referred to as "idiopathic urge incontinence".

detrusan® electrical stimulation therapy is designed to balance the activity of the Detrusor and correct Urge Incontinence.

Stress Urinary incontinence

It is urine leakage caused by physical activity that places “stress” on the bladder and sphincter muscle.

Movements such as sneezing; coughing; laughing or playing sports and other similar activities are particularly problematic. These types of physical activity may cause abdominal muscles to suddenly place pressure on the bladder, or cause too much movement of the urethra within the body.

In all cases, the sphincter muscle (which prevents urine being expelled from the bladder) needs to be healthy and strong to handle the increased pressure placed upon it. The problem may also be exacerbated if there is a weakness or defect of the sphincter muscle known as intrinsic sphincter deficiency.

detrusan® electrical stimulation therapy is designed to exercise the sphincter, this builds the muscle tone required to manage Stress Incontinence.

Mixed Urinary Incontinence

It is a combination of an overactive bladder (see Urge Incontinence) coupled with a weak sphincter muscle (see Stress Incontinence). Due to the various factors involved in the causes of UI, a large proportion of people with Incontinence experience a combination of both conditions.

detrusan® electrical stimulation therapy has been optimized to deliver the necessary stimulation parameters to balance the bladder system. These stimulation parameters are pre-programmed in detrusan® 500 to facilitate therapy once a correct diagnosis has been established. Additional detailed information is available to support specific cases.

Overflow Incontinence

It is a condition that occurs when the bladder never empties completely. It becomes so full that it just overflows. This type of incontinence is more common in men, often because of an obstruction such as an enlarged prostate.

By using a regime similar to that of Stress Incontinence to treat these cases, detrusan® ® therapy strengthens the Detrusor thus making it easier to empty the bladder.