7.urinary incontinence - corc dos drwrk v

7/22/2019 7.Urinary Incontinence - Corc Dos Drwrk V

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Urinary incontinence

Urinary incontinence is any involuntary leakage of urine.

Urinary incontinence the loss of bladder control is a common and oftenembarrassing problem.

The severity of urinary incontinence ranges from occasionally leaking urine when anyperson 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

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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 bladdercauses 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 thesestructures 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 thattime, 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 thesebladder 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 injuryincluding 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

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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 ormore 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 accountfor 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 ofincontinence. 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 transientincontinence. 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 forevidence 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.

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UrodynamicsVarious techniques measure pressure in the bladder and the flow

of urine.

In Ayurvedic perspective,

Urge incontinence

Vata VrddhiChala guna vrddhi

Madhyama roga marga

Vasthi sthanaSuppression of urges should be avoided

Kashayam

Sukumara paal kashayam 60 ml in the evening

Dhanwanthara paal kashayam 60 ml in the evening

Rasaushadhis

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)

Pichu

Dhanwantharam tailam (A.H)

Bala lakshadi

Anuvasanam

Ksheerabala

Dhanwantharam

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Vasthi

Laghu pancha moola ksheera vasti

Dravyam Quantity

Makshikam 100 ml

Sneham Ghrtam (Mahatiktaka ghrtam)

Tailam (Bala tailam)

100 ml

100 ml

Brhtyadi ksheera kashayam 200 ml

Total 500 ml

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

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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

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)

Vati

Manasamitram 2 tablets at night after food (Sahasra Yogam)

Rasaushadhis

Abraka senduram 50 to 100 mg twice daily with milk

Shilajith 1 tablet twice daily after food with milk

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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 offood (Bhaishajya Ratnavali)

Kalyanaka ksharam 1 gram with ghritham twice daily after food (A.H. Chikitsasthana)

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

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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

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7.urinary incontinence - corc dos drwrk v

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