This may occur in children and when associated with bed-wetting is usually termed enuresis. Up to 4-5 years of age this may be quite common, and when persistent usually indicates some psychological distress. Congenital defects in the formation of the urinary organs may contribute to this disorder, and they can be evaluated with a specific x-ray study, the intravenous pyelogram.
Most cases of childhood incontinence subside with the passage of years. Women of childbearing age may have incontinence after the delivery of a large baby. Or with successive pregnancies, the support of the bladder and urethra may be weakened, producing a hernia or prolapse called a cystocele. Often this is associated with stress incontinence on sneezing, coughing, or straining. The Kegel exercises described in the chapter on gynecology are often helpful in alleviating these symptoms. If persistent anatomic defect is demonstrated, surgical repair may be indicated to restore continence and alleviate the anxiety that inhibits social interaction.
Men seldom have incontinence until advanced age. This may occur at times after operations such as a prostatectomy. If the incontinence does not improve during convalescence it should be evaluated by a urologist since research centers have developed a number of surgical approaches to this troublesome problem. Mechanical devices to preserve social acceptance and self-confidence are also available.
Most cases of childhood incontinence subside with the passage of years. Women of childbearing age may have incontinence after the delivery of a large baby. Or with successive pregnancies, the support of the bladder and urethra may be weakened, producing a hernia or prolapse called a cystocele. Often this is associated with stress incontinence on sneezing, coughing, or straining. The Kegel exercises described in the chapter on gynecology are often helpful in alleviating these symptoms. If persistent anatomic defect is demonstrated, surgical repair may be indicated to restore continence and alleviate the anxiety that inhibits social interaction.
Men seldom have incontinence until advanced age. This may occur at times after operations such as a prostatectomy. If the incontinence does not improve during convalescence it should be evaluated by a urologist since research centers have developed a number of surgical approaches to this troublesome problem. Mechanical devices to preserve social acceptance and self-confidence are also available.
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