URINARY INCONTINENCE
Definition:
The loss of voluntary control over urination during the day and night
Etiology:
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urge incontinence: This type of UI is preceded by a morbid desire to urinate. Common causes are bladder
infections, idiopathic, spina bifida occulta, MS, and bladder stones
stress incontinence: This UI occurs following sneezing, coughing, laughing and straining (activities that increase
intra-abdominal pressure) and is due to a somewhat compromised urinary sphincter, It seems to be more common
in post-menopausal women due to atrophy of the urethra; although it can occur in men after prostatic surgery
overflow (paradoxical) incontinence: This occurs when the pressure of an overfilled bladder eventually overcomes
sphincter resistance. The bladder becomes dilated and palpable. Factors involved with this type of UI include:
obstruction to urine outflow (BPH and prostate cancer), urethral meatus stricture (esp. in children), urethral
strictures and injury to the spinal cord
ectopic ureter in women: patients present with leakage day and night their while lives, even though they void
normally. The ureter may be found in the vagina, near the bladder neck, or in the urethra and surgical correction is
necessary. Ectopic urethra in men does not produce UI
psychogenic incontinence: particularly seen in children, this is characterized by a child with normal ability to urinate
but who fakes incontinence to gain some emotional need. A careful diagnostic work-up will uncover no pathology
functional incontinence: This mainly occurs in elderly patients who have hood working urinary parts but cannot reach
the toilet in time due to confusion, drugs or an inability to walk well
urinary fistulas: Usually seen in women following some type of body trauma (gunshot wound, automobile accidents,
neoplasms) where a tract develops either from the ureter, bladder or urethra and empties into the vagina
neurogenic bladder dysfunction: This is due to congenital abnormalities, injuries or disease of the brain, spinal cord
or nerves supplying the bladder
mixed types of incontinence
Signs and Symptoms:
1. involuntary loss of urine
2. other symptoms pertaining to the primary cause of the incontinence
Lab Findings:
1. tests are necessary for a full work-up of the condition, unless the cause is obvious (ie. after a spinal cord injury)
Course/Prognosis:
1. depends on the type of incontinence
2. psychogenic incontinence there is a good prognosis for full return of urinary control as well as in the incontinence is
due to a correctable anatomic abnormality
3. other causes can be harder to treat
Nutrition:
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black beans QD
take 30g of walnut kernels and 2 sliced pork kidneys, stir fry and eat while warm QD for 3 days
For enuresis:
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celery and parsley
take a spoonful of honey straight right before bed (make sure to brush teeth afterward)
eat 10 dried litchis QD
charcoaled raspberry powder, make into a tea and drink before bed
boil cinnamon and licorice tea, add 2 tsp. molasses
Avoid:
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apple or orange juice before bed
Hydrotherapy:
1. cold sitz bath (if from BPH, impotence)
Manipulation:
1. check and align T10-L1
Physiotherapy:
1. spondylotherapy: concussion of T12 to increase tone of sphincters
2. interferential
Botanicals:
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Anemone pulsatilla (toxic): induced by nervous disorders, colds, movement
Arnica montana (toxic): bruised, sore, lacerated, contused muscular tissue, with low fever
Atropa belladonna (toxic): plethoric tendency, capillary congestion, tissues relaxed
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URINARY INCONTINENCE
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Chamaelirium luteum (Helonias): tones pelvic tissue
Claviceps purpurea (toxic): with weakness of bladder
Equisetum arvense: stimulating diuretic for weak lax tissues, for elderly who leak urine, for traces of blood in urine
and ejaculate
7. Equisetum hyemale: nocturnal, with cystic irritation
8. Piper methysticum: with catarrh, tones urinary apparatus
9. Rhus aromatica (toxic): of children and aged, tones musculature, combines well with Equisetum arvense, Viburnum
opulus, Ephedra vulgaris
10. Serenoa serrulata: incontinence in children and aged
11. Thuja occidentalis: due to weak bladder sphincter, dribbling with cough, sneeze, esp. for elderly who pass foul urine,
also for dribbling of urine
Formulas:
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incontinence with chronic disorders:
Achillea millefolium + Pimpinell anisum (oil)
Homeopathy:
1. Arsenicum album: during pregnancy
2. Belladonna: continuous dribbling
3. Causticum: involuntary urinating when coughing, laughing or sneezing; from slightest excitement, during first part of
sleep, on becoming cold, unconscious of stream as it passes
4. Equisetum: paralysis of bladder in old women
5. Ferrum phosphoricum: during the day, diurnal enuresis
6. Hepar sulphur: with atony of muscular coats, urine passes slowly; passes perpendicularly instead of being ejected
with some force esp. old men; bed wetting at night
7. Pulsatilla: during pregnancy; during cough; at night; when expelling flatus; while sitting or walking; slightest
excitement; sudden noises; must keep her mind continually on it or she will lose it; dribbling uterine fibroids,
myometrial growths of the uterus (fibromyoma or leiomyoma)
8. Thuja: disorders of urinary retention
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