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Military recruits often
have difficulty urinating
regularly due to special
circumstances such
as basic military
training. Some recruits
complain voiding symptoms,
like frequency, urgency,
and incontinence after
joining the military.
Recruit incontinence
is a term used in
this study to describe
military recruit suffering
incontinence but have
no prior history of
incontinence before
joining the military
and do not have relevant
associated conditions,
such as urinary tract
infection, neurological
disorder or anatomical
abnormality of lower
urinary tract. The
cause of recruit incontinence
was unclear and required
warranted investigation.
Methods:
Author examined 15
military patients
who had recruit incontinence.
All the patients were
men with mean age
of 21.7 (range 21-23).
Patients’ assessment
consisted of history,
combined symptoms,
psychiatric problem,
and urodynamic study
(cystometry and pressure-flow-EMG
study).
Results:
Some of the patients
had frequency (60.0%)
and enuresis during
childhood (26.7%)
before joining the
military. All of the
patients, while undergoing
basic military training,
were severely restrained
from urinating due
to various factors,
making their urination
patterns irregular.
So all of them had
to extensively hold
their urine numerous
times during basic
training. The examined
patients had combined
symptoms of frequency
(93.3%), urgency (80.0%),
intermittent lower
abdominal pain (60.0%)
and hesitancy (53.3%).
After psychiatric
consultation, two
of the examined patients
had mild depression,
but did not require
medication. Urodynamic
study of the 15 patients
showed that the first
sensation of bladder
fullness was 42-125
ml (average: 85 ml)
and the bladder capacity
was 170-450 ml (average: 253
ml), and 12 (80.0%)
of the patients had
detrusor instability.
However, none of the
patients showed detrusor
external sphincter
dyssynnergia. The
patients received
conservative therapy
like bladder training
and medication. During
a mean follow-up period
of 11.2 months (range
8-17 months), two
patients (13.3%) had
complete resolution,
nine (60.0%) had improvement,
but four (26.7%) did
not.
Conclusions:
Patients suffering
from recruit incontinence
had histories of severely
restrained urination
and irregular urination
patterns. Urodynamic
study found that 80.0%
of the patients had
detrusor instability.
Recruit incontinence
is closely related
to idiopathic detrusor
instability, and further
study of recruit incontinence
will provide helpful
information in understanding
idiopathic detrusor
instability.
