Kwa historia ya zamani ya kujikojolea na hii ya sasa ya kukojoa mara kwa mara , na kama kuna muda unapata hamu ya kukojoa ila ukienda unapata mkono kidogo tu unaweza kua na tatizo linaitwa "Overactive bladder syndrome" ambalo hutokana na shida ya mfumo wa fahamu unaosupply kibofu kuruhusu kubana na kuachia mkojo , matibabu yake yapo kwa dawa na mazoezi angalau kwa miezi mitatu na kuendelea , Kuna dawa nzuri sana inaitwa Oxybutynin ukifanya na mazoezi ya pelvic floor muscles utapata matokeo mazuri sana.
Onana na urologist alie karibu na wewe akupe mpangilio mzuri wa matibabu.
Mkuu Pole na maradhi yako na mimi nina changia kama walivyo changia wenzangu kuwa unatakiwa ukapime maradhi ya aiana 3 ya njia ya mkojo Maradhi yenyewe ni overactive bladder, au Enlarged Prostate, au Urinary incontinence Hiyo ya mwisho aka Urinary incontinence yaani unakojoa wakati hutaki hata kukojoa kutokana na udhaifu wakibofu chako cha mkojo kutozuia mkojo wako. Na uangalie tena katika figo lako je hayo maambukzi yamekwisha?Ingawa huja tuambia wewe ni mwanamke au Mwanamume?
Urinary incontinence
Urinary incontinence (
UI), also known as
involuntary urination, is any uncontrolled leakage of urine. It is a common and distressing problem, which may have a large impact on quality of life.[1] It has been identified as an important issue in geriatric health care.[2] The term enuresis is often used to refer to urinary incontinence primarily in children, such as nocturnal enuresis (bed wetting).[3]
Pelvic surgery, pregnancy, childbirth, and menopause are major risk factors.[4] Urinary incontinence is often a result of an underlying medical condition but is under-reported to medical practitioners.[5] There are four main types of incontinence:[6]
- Urge incontinence due to an overactive bladder
- Stress incontinence due "a poorly functioning urethral sphincter muscle (intrinsic sphincter deficiency) or to hypermobility of the bladder neck or urethra"[7]
- Overflow incontinence due to either poor bladder contraction or blockage of the urethra
- Mixed incontinence involve features of different other types
Treatments include pelvic floor muscle training, bladder training, surgery, and electrical stimulation.[8] Behavioral therapy generally works better than medication for stress and urge incontinence.[9] The benefit of medications is small and long term safety is unclear.[8] Urinary incontinence is more common in older women.[10]
Causes
Urinary incontinence can result from both urologic and non-urologic causes. Urologic causes can be classified as either bladder dysfunction or urethral sphincter incompetence and may include detrusor overactivity, poor bladder compliance, urethral hypermobility, or intrinsic sphincter deficiency. Non-urologic causes may include infection, medication or drugs, psychological factors, polyuria, stool impaction, and restricted mobility.[11] The causes leading to urinary incontinence are usually specific to each sex, however, some causes are common to both men and women.
Women
Pelvic floor muscles in women
The most common types of urinary incontinence in women are stress urinary incontinence and urge urinary incontinence. Women that have symptoms from both types are said to have "mixed" urinary incontinence. After menopause, estrogen production decreases and, in some women, urethral tissue will demonstrate atrophy, becoming weaker and thinner, possibly playing a role in the development of urinary incontinence.[4]
Stress urinary incontinence in women is most commonly caused by loss of support of the urethra, which is usually a consequence of damage to pelvic support structures as a result of pregnancy, childbirth, obesity, age, among others.[12] About 33% of all women experience urinary incontinence after giving birth, and women who deliver vaginally are about twice as likely to have urinary incontinence as women who give birth via a Caesarean section.[13] Stress incontinence is characterized by leaking of small amounts of urine with activities that increase abdominal pressure such as coughing, sneezing, laughing and lifting. This happens when the urethral sphincter cannot close completely due to the damage in the sphincter itself, or the surrounding tissue. Additionally, frequent exercise in high-impact activities can cause athletic incontinence to develop. Urge urinary incontinence, is caused by uninhibited contractions of the detrusor muscle, a condition known as overactive bladder syndrome. It is characterized by leaking of large amounts of urine in association with insufficient warning to get to the bathroom in time.
Men
The prostate with the urethra passing through it (prostatic urethra)
Urge incontinence is the most common type of incontinence in men.[14] Similar to women, urine leakage happens following a very intense feeling of urination, not allowing enough time to reach the bathroom, a condition called overactive bladder syndrome. In men, the condition is commonly associated with benign prostatic hyperplasia (an enlarged prostate), which causes bladder outlet obstruction, a dysfunction of the detrusor muscle (muscle of the bladder), eventually causing overactive bladder syndrome, and the associated incontinence.[14]
Stress urinary incontinence is the other common type of incontinence in men, and it most commonly happens after prostate surgery.[15] Prostatectomy, transurethral resection of the prostate, prostate brachytherapy, and radiotherapy can all damage the urethral sphincter and surrounding tissue, causing it to be incompetent. An incompetent urethral sphincter cannot prevent the urine from leaking out of the urinary bladder during activities that increase the intraabdominal pressure, such as coughing, sneezing, or laughing. Continence usually improves within 6 to 12 months after prostate surgery without any specific interventions, and only 5 to 10% of people report persistent symptoms.[14]
Both
- Age is a risk factor that increases both the severity and prevalence of UI
- Polyuria (excessive urine production) of which, in turn, the most frequent causes are: uncontrolled diabetes mellitus, primary polydipsia (excessive fluid drinking), central diabetes insipidus and nephrogenic diabetes insipidus.[16] Polyuria generally causes urinary urgency and frequency, but does not necessarily lead to incontinence.
- Neurogenic disorders like multiple sclerosis, spina bifida, Parkinson's disease, strokes and spinal cord injury can all interfere with nerve function of the bladder.[17] This can lead to neurogenic bladder dysfunction
- Overactive bladder syndrome. However, the etiology behind this is usually different between men and women, as mentioned above.
- Other suggested risk factors include smoking, caffeine intake and depression
Mechanism
Anatomy of the lower urinary tract and genital system
Adults
The body stores urine — water and wastes removed by the kidneys — in the urinary bladder, a balloon-like organ. The bladder connects to the urethra, the tube through which urine leaves the body.
Continence and micturition involve a balance between urethral closure and detrusor muscle activity (the muscle of the bladder). During urination, detrusor muscles in the wall of the bladder contract, forcing urine out of the bladder and into the urethra. At the same time, sphincter muscles surrounding the urethra relax, letting urine pass out of the body. The urethral sphincter is the muscular ring that closes the outlet of the urinary bladder preventing urine to pass outside the body. Urethral pressure normally exceeds bladder pressure, resulting in urine remaining in the bladder, and maintaining continence.[18] The urethra is supported by pelvic floor muscles and tissue, allowing it to close firmly. Any damage to this balance between the detrusor muscle, urethral sphincter, supportive tissue and nerves can lead to some type of incontinence .
For example, stress urinary incontinence is usually a result of the incompetent closure of the urethral sphincter. This can be caused by damage to the sphincter itself, the muscles that support it, or nerves that supply it. In men, the damage usually happens after prostate surgery or radiation,[14] and in women, it's usually caused by childbirth and pregnancy.[19] The pressure inside the abdomen (from coughing and sneezing) is normally transmitted to both urethra and bladder equally, leaving the pressure difference unchanged, resulting in continence. When the sphincter is incompetent, this increase in pressure will push the urine against it, leading to incontinence.
Another example is urge incontinence. This incontinence is associated with sudden forceful contractions of the detrusor muscle (bladder muscle), leading to an intense feeling of urination, and incontinence if the person does not reach the bathroom on time. The syndrome is known as overactive bladder syndrome, and it's related to dysfunction of the detrusor muscle.[20]