7.Urinary Incontinence - Corc Dos Drwrk V
-
Upload
venkatesan-vidhya -
Category
Documents
-
view
216 -
download
0
Transcript of 7.Urinary Incontinence - Corc Dos Drwrk V
-
7/22/2019 7.Urinary Incontinence - Corc Dos Drwrk V
1/8
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
1
-
7/22/2019 7.Urinary Incontinence - Corc Dos Drwrk V
2/8
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
2
-
7/22/2019 7.Urinary Incontinence - Corc Dos Drwrk V
3/8
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.
3
-
7/22/2019 7.Urinary Incontinence - Corc Dos Drwrk V
4/8
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
4
-
7/22/2019 7.Urinary Incontinence - Corc Dos Drwrk V
5/8
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
5
-
7/22/2019 7.Urinary Incontinence - Corc Dos Drwrk V
6/8
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
6
-
7/22/2019 7.Urinary Incontinence - Corc Dos Drwrk V
7/8
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
7
-
7/22/2019 7.Urinary Incontinence - Corc Dos Drwrk V
8/8
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
8