Total urinary incontinence refers to the continuous leakage of urine day and night . The bladder is unable to retain any urine at all.
- Damage to the external urinary sphincter : This occurs when the muscles or the nerve supply to the sphincter is damaged, for example after prostate surgery or after sustaining a serious pelvic injury. (Fig. 1)
- Fistula formation: Total or continuous leakage also occurs when an abnormal passageway known as a fistula is formed between the urinary system and the vagina. (Fig. 2)
Treatment for total incontinence depends on the cause. If a fistula is present, surgery may be able to close the leak.
In sphincteric damage, artificial sphincters may be implanted if the underlying disease process is amenable to surgical removal/correction. If this is not possible, urinary diversion may be considered.
If surgery is not possible or inadvisable, patients may have to rely on continence aids, catheters or absorbent products.
Washable pants / briefs