Incontinence
Cause is by a new or recent medical problem that can be treated.
Medical conditions such as urinary retention, fecal impaction/constipation,
urinary tract infection and atrophic vaginitis can cause an onset.
If one of these problems is identified, treatment to correct the
problem should be started. Once the medical problem causing the
incontinence is resolved, the incontinence should improve. In
addition to medical problems, certain medications can cause or
contribute to an incontinence problem.
There are basically four kinds of Incontinence
Cause: Stress, Urge, Overflow, and functional incontinence.
They may occur alone, as is usually the case in the young adult,
or in combination, as seen the elderly.
Stress Incontinence
Cause:
Stress Incontinence is an involuntary loss of urine that occurs
during physical activity, such as coughing, sneezing, laughing,
or exercise.
Stress Incontinence is a bladder storage problem in which the
strength of the urethral sphincter is diminished, and the sphincter
is not able to prevent urine flow when there is increased pressure
from the abdomen.
Stress Incontinence may occur as a result of weakened pelvic
muscles that support the bladder and urethra, or because of malfunction
of the urethral sphincter. Prior trauma to the urethral area,
neurological injury, and some medications may weaken the urethra.
Sphincter weakness may occur in men following prostate surgery
or in women after pelvic surgery. Stress Incontinence is often
seen in women who have had multiple pregnancies and vaginal childbirths,
or who have pelvic prolapse (protrusion of the bladder, urethra,
or rectal wall into the vaginal space), with cystocele, cystourethrocele,
or rectocele.
Studies have documented that about 50% of all women have occasional
urinary incontinence, and as many as 10% have frequent incontinence.
Nearly 20% of women over age 75 experience daily urinary incontinence.
Stress Iincontinence is the most common type of urinary incontinence
in women. Risk factors for Stress Incontinence include female
sex, advancing age, childbirth, smoking, and obesity. Conditions
that cause chronic coughing, such as chronic bronchitis and asthma,
may also increase the risk of Stress Incontinence.
Urge Incontinence
Cause
Urge incontinence involves a strong, sudden need to urinate immediately
followed by a bladder contraction, resulting in an involuntary
loss of urine.
Urge incontinence is basically a storage problem in which the
bladder muscle contracts inappropriately. Often these contractions
occur regardless of the amount of urine that is in the bladder.
Urge incontinence may result from neurological injuries (such
as spinal cord injury or stroke), neurological diseases (such
as multiple sclerosis), infection, bladder cancer, bladder stones,
bladder inflammation, or bladder outlet obstruction.
The majority of cases are classified as idiopathic -- a specific
cause cannot be identified.
Although urge incontinence may occur in anyone at any age, it
is more common in women and the elderly. It is second only to
stress incontinence as the most common cause of urinary incontinence
(involuntary loss of urine). Approximately 1% to 2% of adult females
are affected by urge incontinence.
In men, urge incontinence may be due to secondary bladder injuries
caused by benign prostatic hypertrophy (BPH) or bladder outlet
obstruction from an enlarged prostate.
Symptoms
Sudden and urgent need to urinate (urinary urgency)
Frequent urination, in the daytime and at night
Abdominal distention or discomfort
Involuntary loss of urine
Overflow Incontinence
Cause
People with overflow incontinence do not feel the urge to urinate.
The bladder never empties normally and remains at least partially
full; small amounts of urine are leaked on a nearly continuous
basis. Weak bladder muscles -- caused by nerve damage from diabetes
or other diseases -- or a blocked urethra can be responsible for
overflow incontinence.
Overflow incontinence most frequently appears in older men in
whom an enlarged prostate hinders the flow of urine; urinary stones
or tumors also may block the urethra. Overflow incontinence is
rare in women, although sometimes it is caused by fibroid or ovarian
tumors. Spinal cord injuries or nervous system disorders are additional
causes of overflow incontinence.
Some of the symptoms of overflow incontinence are:
Feeling as though the bladder is never completely empty.
Feeling the urge to urinate, but not being able to.
Passing a dribbling stream of urine, even after spending a long
time at the toilet.
Frequently getting up at night to urinate.
Although some people with overflow incontinence never have the
feeling of a full bladder, they may leak urine day and night.
Functional Incontinence
Cause
Functional incontinence may occur after a major illness or in
nursing homes. It accounts for 25% of the incontinence seen in
hospitals and results when a person has difficulty moving from
one place to another. Impairments (including poor vision, hearing,
or speech which may influence success in reaching facilities and
inability to notify caregivers of the need to use the bathroom)
can cause functional incontinence. The person's home environment,
such as a readily accessible bathroom, may cause incontinence.
Usually the person complains that she/he "cannot hold my
urine until I can get to the bathroom". This is usually due
to decreased mental function, decreased functional status, and/or
unwillingness to go to the toilet.
