Continence and micturition involve a balance between urethral closure and detrusor muscle activity. Urethral pressure normally exceeds bladder pressure, resulting in urine remaining in the bladder. The proximal urethra and bladder are both within the pelvis. Intra-abdominal pressure increases (from coughing and sneezing) are transmitted to both urethra and bladder equally, leaving the pressure differential unchanged, resulting in continence.
The overall prevalence of urinary incontinence was 54.5%, higher in women (59.8%) than in men (39.2%). The prevalence increased significantly with age, from 26.5% in subjects 65 years old or younger to 73.7% in subjects 95 years old or older; with worsening of mental status, from 36.2% in well-oriented subjects to 76.7% in poorly oriented subjects; and with worsening of mobility, from 23.8% in self-sufficient subjects to 82.1% in bedridden patients.
Treatment is keyed to the type of incontinence. The usual approaches are as follows: • Stress incontinence - Surgery, pelvic floor physiotherapy, anti-incontinence devices, and medication • Urge incontinence - Changes in diet, behavioral modification, pelvic-floor exercises, and/or medications and new forms of surgical intervention • Mixed incontinence - Anticholinergic drugs and surgery
Stem cells, which can develop into many possible cells or organs, are an area of intense study by scientists interested in managing or curing a wide array of serious health conditions. For this study, researchers from Finland and the Netherlands treated five women suffering from stress incontinence with adipose (fat-derived) stem cells combined with bovine collagen gel -- a bulking agent -- and saline solution. The women either didn't want to undergo the mesh procedure, known as midurethral sling surgery, or had undergone unsuccessful mesh implants.