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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to understand the pathology of incontinence, it is important to investigate urinary symptoms, urological and neurological examinations and urodynamics. There are two kinds of incontinence. One is true incontinence in which urine passes through urethra, and the other is false incontinence due to the ectopic opening of the ureter, for example to the vagina. The former includes stress incontinence, urge incontinence, reflex incontinence, overflow incontinence and total incontinence. Stress incontinence occurs with the sudden increase of abdominal pressure such as cough, running and exertion. The cause of stress incontinence is thought to be weakening of pelvic floor muscles after delivery or aging. In these patients, the bladder base and urethra move downwards and backwards, which make the posterior vesico-urethral angle more than 120 degrees. Treatment of stress incontinence includes pelvic floor exercise, administration of alpha-stimulants which increase the tonus of the internal sphincter and surgery to elevate the urethra. Urge incontinence is observed when detrusor instability occurs. It is also seen in patients with neurological diseases such as multiple cerebral infarction or with benign prostatic hypertrophy (BPH). Treatment of urge incontinence includes administration of anticholinergics to decrease bladder hyperreflexia. Reflex incontinence is seen in patients with spinal cord disorders. It occurs due to reflex contraction of detrusor and the treatment involves administration of anti-cholinergics. Overflow incontinence is seen in patients with voiding difficulties due to BPH. It occurs when residual urine increases and when the intravesical pressure exceeds urethral pressure on body movement. Treatment for this is intended to improve voiding difficulties. Total incontinence occurs when total sphincter function is damaged.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The pathology and treatment of incontinence]. 159 84

Urinary incontinence, the inability to retain urine, creates a misery that cannot be overestimated. The foul odor emanating from the patient repels family and friends to such an extent that it affects the social life of the sufferer. Total incontinence, that is, the continuous loss of urine as opposed to the loss associated with coughing or sneezing, is the most severe type of the malady. For such individuals, the artificial sphincter offers hope for a new life. Incidences of total urinary incontinence as a result of radical prostatectomy in the treatment of carcinoma of the prostate have been reported in the range of 5-50%. Incontinence may occur as a result of injury to the proximal urethra, and it is usually present to some extent in patients with neurogenic bladder dysfunction caused by spinal cord injury, myelomeningocele, or other conditions that affect the micturition centers of the nervous system. Some patients whose urinary tract is completely obstructed and who are therefore unable to urinate, as for example individuals who sustain traumatic complete transection of the urethra with resulting obstructive fibrosis of the urethra, or those patients whose neurogenic spastic sphincter inhibits satisfactory voiding, may benefit from reconstructive surgery or ablation of their pathologic sphincter in order to restore urination. Rehabilitation of such patients can then be complete with implantation of an artificial sphincter to provide urinary control. The alternatives for management include diapers, the placement of external collecting or occlusive devices, or major surgery in which the intestinal tract is used either for conducting the urine to an abdominal collecting bag or as a bladder substitute that is periodically emptied by catheterization.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The artificial urinary sphincter: review and progress. 305 Mar 89