Introduction

Urinary incontinence is a common and yet, embarrassing health problem which people avoid talking about to their health practitioners. It affects mostly women and it has been estimated that 25 millions Americans and 800, 000 Australians may be suffering from this condition. Urinary incontinence can affect women in their young age such as after birth to menopausal and elderly women.

From an integrative Chinese medicine perspective, functional urinary incontinence is a sign of premature aging and early degeneration. This condition should be taken seriously and treated accordingly.

Definition

Unable to control the voiding of urine without structural abnormalities
stress incontinence: urine loss or leakage during straining or physical activities such as laughing, coughing or exercise

urge incontinence: urine loss or leakage occur after experiencing urgency before reaching the toilet

mixed incontinence: combination of both stress and urge incontinence

overflow incontinence: urine loss occur when the bladder is full and failed to contract properly

total incontinence: constant loss of urine

Accompanying signs & symptoms

urine loss during exercise, coughing, abdominal straining, laughing, bowel motion or even during sex, frequent urination without excessive fluid intake, wake to go to the toilet during the night, weak voiding or small quantity of voiding
Other accompanying signs and symptoms: swollen knees and ankles, soreness in the lower back, poor memory and forgetfulness, fatigue and low energy, low libido, early greying of hair

Possible Causes

History of many child birth
History of difficult, troubled or long child birth
Excessive physical exhaustion
Excessive sexual activities
History of other medical conditions such as stroke
History of seizures or epilepsy
History of poor diet and lifestyle

History of prostate problems

Physiological Mechanisms

Functional urinary incontinence is a complicated condition as a normal continence function or activity involves the co-ordination of multiple mechanisms and systems in the body. Two key mechanisms are required: neural and hormonal mechanisms for filling and detecting and acting mechanism for voiding/emptying of bladder. 

Neural and hormonal mechanisms are nerves and hormones which determine the rate and detect the filling of bladder. Signals are sent to the brain informing about voiding. Once the brain is informed, then, it instruct the body to void at appropriate time and place.

From integrative Chinese medicine perspective, functional urinary incontinence often occur when one of the mechanisms become dysfunctional, overactive or under-active. Excessive use of diuretic substances such as coffee, tea or certain medication cause an imbalance in nerve activities and hormonal secretion. This may result in fast filling of bladder and frequent urination. Cumulative use of caffeine causes adrenal fatigue, physical exhaustion and thus urinary incontinence.

Injuries and strains of the pelvic floor muscles and associated nerves during child birth result in weakening of the muscular structure and induce muscular fatigue. If this weakening and fatigue fail to recover, it often result in functional urinary incontinence.

Treatment Modalities

Specialist Acupuncture for 12 sessions. 2 sessions per week for the first 3 weeks. Chinese herbal treatment may be required.

Mechanism of action of the herbs used

Acupuncture and Chinese medicine treats the condition by doing the following:
Regulating neural activities for urine control
Strengthen the muscles and reduce muscle fatigue, facilitating muscular recovery of pelvic floor muscles from past injuries or straining such as childbirth
Regulating hormonal mechanisms which associated with bladder control and voiding
Promoting rejuvenation and anti aging 
Regulating the hormones relating to the filling of bladder

Health Advice

Reducing the intake of caffeine and cigarette smoking
Eat a balance diet
Establishing a regular eating habit
Encouraging moderate, regular and outdoor exercises

References

Longman concise medical dictionary, 1994

Chinese-English Manual of Common-Used in Traditional Chinese Medicine, Ou Ming, 1995

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