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We know that kidney purifies the blood. It sends the impurities to bladder via ureter. These impurities are known as urine. When the sufficient amount of urine is stored in bladder, its muscles gets contracted. Which applies pressure on to the inside wall of the bladder. This situation is known as urge of urinating. When we reach in toilet, the pelvic floor muscles located at the opening end of the bladder gets opened. Then urines are released out of the body via urethra. 
The symptoms include leaking urine, frequent urination due to overactive bladder and other symptoms of urinary incontinence. Improvements in the field of urology and gynecology have helped a lot in curing such problems. Though bladder may contain very small amount of urine, but still it make a frequent and sudden urge of urinating. This phenomenon is also referred as Urge Incontinence (UI). It is a form of urinary incontinence (unintentional loss of urine). Another phenomenon is referred as Stress Incontinence (SI) where the valves which hold the urine in bladder are affected and urine cannot be hold for more periods. 
Urinal Incontinence (UI) (Overactive Bladder)
As we know that kidneys keep producing urine, which is then passed to the bladder via ureters as shown in the figure. It is stored in bladder, which is a balloon like arrangement; it expands as the urine is filled in it. Once the bladder is full it sends signal to the brain, which gives order to pelvic floor muscle to release the urine. Then urine comes out from body via urethra. 
When bladder is not full, it contracts suddenly without having any control. It increases urgency and frequency of urine. The patient feel sudden urge to urinate, whether her bladder is full or not. Sometimes female has to wear sanitary pads in such cases. One also faces the frequent urination problem where if they urinate normally seven-eight times a day, then they have to urinate many more times in a day. Even they have to urinate in nights as well. 
There are no any common causes like urinal infection, kidney problem or prostate enlargement. The exact causes are not fully understood, but when bladder muscle becomes over sensitive, then this problem occurs.
In UI, the detrusor muscles are responsible. Normally, an empty bladder begins to get full. At this point, the detrusor is relaxed. When bladder becomes half full, the detrusor sends the signal to brain. Usually at this point of time, people can control on their urinating urge. When the bladder gets full, the detrusor sends signal to brain, the muscles contract, the valve opens and urine comes out from the body via urethra. 
Improve food habits – like avoiding caffeine in tea, coffee, cola, etc., and by alcohol 
Bladder Drill
•     Training of a bladder is called as “Bladder Drill”
•     It is the process of slowly stretching the bladder so that it can hold more urine. 
•     When patient feels urge to urinate, he is advised to hold the urine for some more time. Thus he gives practice to bladder to hold more urine.
•     It results in increasing more time to pass the urine. 
•     One can note down the timings and amount of urine, so as to compare date by date and week by week. 
•     Ultimate aim is to hold more urine and to pass urine only 6-7 times in a day. 
•     The entire exercise would require few months, but there after bladder gets used to hold more urine. 
Stress Incontinence (SI)
The phenomenon of losing urine without any meaning during physical activities such as coughing, sneezing, laughing or exercise is referred as Stress Incontinence.
As in Urinary Incontinence, the detrusor muscles are responsible, similarly in Stress Incontinence, the sphincter muscles are responsible. They support the bladder and the urethra. They keep holding the urine so that it is not leaked. But due to some reasons the sphincters are not working as desired and hence there is a urine leakage. This situation is majorly seen in women rather than men. The possible reasons are due to
•     Child Birth
•     Injury near urethra area
•     Due to some medications
•     Surgery in the prostate or pelvic area
•     Vaginal infection
Avoiding smoking, caffeinated drinks such as tea, coffee, alcohol etc. gives positive result in such cases. The patient is advised to keep diary to note down the number of times and volume of urine. There are several ways of treatment such as
•     Change in Behavior
•     Medication
•     Pelvic muscle training
•     Surgery 
Change in Behavior:
•     Avoid more physical exercise
•     Drink sufficient water, not take more than necessary
•     Avoid jumping; try not to go in dusty area so as to avoid coughing and sneezing.
•     Keep moderate weight
•     Avoid smoking and drinking alcohol 
•     It is advisable to consult any urologist for such problem. 
Pelvic Floor Muscle Training
•     There are some pelvic muscle exercises to help control urine leakage. 
•     Use device such as Vaginal Cone
•     Electrical Stimulation Therapy is also advised by doctors in such cases. 
•     Once exact cause of urinal incontinence is found, patient can opt for surgery. We recommend visiting urologist to consult for the surgery.
Urinal Incontinence and Stress Incontinence are embarrassing situations which make the patient under extreme shame in the public place. It is highly recommended to consult your urologist if you are facing such problem. For women, it is highly recommended to take immense care at the time of the child birth, because it is the situation when there is maximum chance of getting bladder infection.

Article By: Center for Robotic Surgery

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