Classification of urinary incontinence

  The clinical manifestations of urinary incontinence can be divided into 5 categories: overflow incontinence, non-resistant incontinence, reflex incontinence, urge incontinence and stress incontinence.  1, overflow incontinence is due to more serious mechanical (such as prostatic hyperplasia) or functional obstruction of the lower urinary tract causing urinary retention, when the pressure in the bladder rises to a certain level and exceeds the resistance of the urethra, urine is constantly dripping out of the urethra. The bladder in such patients is distended. Treatment needs to start with the release of lower urinary tract obstruction.  2. Non-resistance incontinence is due to complete loss of urethral resistance and the inability to store urine in the bladder, with all urine flowing from the urethra when the patient is standing. Most of them are caused by the loss of urethral sphincter function, such as urinary incontinence after radical prostatectomy, treatment requires the installation of artificial sphincter, etc.  3, reflex incontinence is caused by complete upper motor neuron lesions, urination relies on spinal reflexes, the patient involuntarily intermittent urination (intermittent incontinence), urination without feeling.  4, Urge incontinence can be caused by partial upper motor neuron lesions or strong local irritation such as acute cystitis, and patients have very severe symptoms of urinary frequency and urgency. Urge incontinence occurs due to strong uninhibited contraction of the detrusor muscle. It can be relieved by pelvic floor exercises and taking M-blockers, and in severe cases, a bladder pacemaker is required.  5, stress incontinence is when the abdominal pressure increases (such as coughing, sneezing, going down the stairs or running) that there is urine flow from the urethra. Stress incontinence is mainly related to the pelvic floor muscles and urethral sphincter relaxation and incomplete closure. Mild cases can be relieved by pelvic floor exercises, and moderate to severe cases can be cured by minimally invasive sling surgery.