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What Causes Urinary Incontinence?
Question: Hi, I have the following symptoms and I'm looking for something to set my doctor on the right track if possible.
> Age 54
> Problems have been there but very mild for as long as I can remember, never been a problem really until lately.
> Urine - much more that a few drops leaking after urination, I shake and milk from very low in the groin area but it still comes out, which could be the cause of my first ever two bouts of balanitis in the past two months.
> After ejaculation, only a small amount comes out if I strain, the rest (majority) comes out afterwards and requires milking again from very low in the groin area.
> Prostate checked out fine, several times.
> I have been tested for every std known to man, so no issues there.
> I've been to several doctors who usually pick one symptom and test for that, but I can't get them to look at the whole picture as possibly connected.
Any thoughts or advice is much appreciated.
> Age 54
> Problems have been there but very mild for as long as I can remember, never been a problem really until lately.
> Urine - much more that a few drops leaking after urination, I shake and milk from very low in the groin area but it still comes out, which could be the cause of my first ever two bouts of balanitis in the past two months.
> After ejaculation, only a small amount comes out if I strain, the rest (majority) comes out afterwards and requires milking again from very low in the groin area.
> Prostate checked out fine, several times.
> I have been tested for every std known to man, so no issues there.
> I've been to several doctors who usually pick one symptom and test for that, but I can't get them to look at the whole picture as possibly connected.
Any thoughts or advice is much appreciated.
Brief Answer:
Evaluation for urinary incontinence and overactive bladder
Detailed Answer:
Hi, thanks for posting your concern in the HCM.
The symptoms you mentioned is that of urine incontinence. Firstly, this needs to be properly classified for rational management. From the history, it seems that you may be having urge or mixed incontinence and/or overactive bladder. The later is more likely from the symptoms. Tests are there to evaluate the same. Secondly, as you have a history of recurrent balanitis, that might have been the precipitating factor and for that reason any urethral abnormality like stricture should be evaluated and ruled out. Alongwith the same, any longstanding bacteriuria (asymptomatic) should be ruled out.
Therefore, the following tests are needed for further evaluation-
Complete blood count, urea, creatinine, fasting TSH, fasting sugar
Urine for routine examination
Urodynamic study and cystoscopy
After these tests, results can be evaluated and analysed for final diagnosis and specific treatment can be started.
I need a few information too-
1. Do you have diabetes, hypertension, hypothyroidism or any other chronic illness?
2. Do you have any history of burning during micturation and/or nocturia?
3. Do you have any history of recent fever?
4. Do you take any regular medicine other than those you mentioned for balanitis?
Now, a few recommendations that may be followed till test results are available-
Avoid stress
Plenty of oral fluid (preferably>3 lit/day)
Pelvic floor physiotherapy
Avoid masturbation and sexual intercourse for a week
Uriliser syr 10ml twice daily
In case there is any urethral stricture, surgical treatment may be needed.
You should also consult a local urosurgeon for further clinical evaluation and comply to the treatment.
After having the tests done, please write back with your reports for further management.
If you are satisfied with the answer, you can close the thread and rate my answer.
Regards,
Dr. Kaushik Sarkar
Evaluation for urinary incontinence and overactive bladder
Detailed Answer:
Hi, thanks for posting your concern in the HCM.
The symptoms you mentioned is that of urine incontinence. Firstly, this needs to be properly classified for rational management. From the history, it seems that you may be having urge or mixed incontinence and/or overactive bladder. The later is more likely from the symptoms. Tests are there to evaluate the same. Secondly, as you have a history of recurrent balanitis, that might have been the precipitating factor and for that reason any urethral abnormality like stricture should be evaluated and ruled out. Alongwith the same, any longstanding bacteriuria (asymptomatic) should be ruled out.
Therefore, the following tests are needed for further evaluation-
Complete blood count, urea, creatinine, fasting TSH, fasting sugar
Urine for routine examination
Urodynamic study and cystoscopy
After these tests, results can be evaluated and analysed for final diagnosis and specific treatment can be started.
I need a few information too-
1. Do you have diabetes, hypertension, hypothyroidism or any other chronic illness?
2. Do you have any history of burning during micturation and/or nocturia?
3. Do you have any history of recent fever?
4. Do you take any regular medicine other than those you mentioned for balanitis?
Now, a few recommendations that may be followed till test results are available-
Avoid stress
Plenty of oral fluid (preferably>3 lit/day)
Pelvic floor physiotherapy
Avoid masturbation and sexual intercourse for a week
Uriliser syr 10ml twice daily
In case there is any urethral stricture, surgical treatment may be needed.
You should also consult a local urosurgeon for further clinical evaluation and comply to the treatment.
After having the tests done, please write back with your reports for further management.
If you are satisfied with the answer, you can close the thread and rate my answer.
Regards,
Dr. Kaushik Sarkar
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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