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Why am I having urinary incontinence?

Q: I am a 27 years old housewife suffering from urinary incontinence for the past ten years. The problem worsens while sneezing, coughing and laughing. I underwent urodynamic test twice. Three months back, urodynamic test showed that my bladder capacity is only 22 ml. Now, I am taking the medicine – Zydus, but still find difficulty in controlling urine. How can urinary incontinence be managed?

A:According to your description, you mostly likely have mixed urinary incontinence along with very small capacity bladder (22 ml). I believe you are taking one of anti-cholinergic medicine, which is not helping. You need to see a urologist for a detailed history, examination, urine tests, cystoscopy and other tests. Certainly, other newer anti-cholinergic medications may be tried. Chronic infections like tuberculosis should also be ruled out for such a small capacity bladder. Patients with interstitial cystitis may need bladder hydrodistension to increase the bladder capacity. Rarely, bladder augmentation procedure may be needed especially in refractory cases where the bladder capacity is very small.

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