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Urinary incontinence

AGE  More common with increasing ageGENDER  More common in females
LIFESTYLE  Risk factors depend on the typeGENETICS  Risk factors depend on the type

Urinary incontinence is a complete or partial loss of voluntary control over bladder function.

Urinary incontinence
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Normally, muscles in the bladder wall push the urine out of the bladder, while muscles in the neck of the bladder and urethra (the tube from the bladder to the outside of the body) control the opening and closing of the bladder outlet. Any disorder affecting these muscles or their nerve supply can result in a partial or complete loss of bladder control.

Urinary incontinence becomes more common with increasing age. The condition is more common in women than in men. It sometimes accompanies dementia or stroke.

What are the types?

There are four main types of incontinence: stress, urge, overflow, and total. The symptoms and treatment are different for each type.

The most common type of incontinence is stress incontinence, in which small amounts of urine are expelled involuntarily.

People who have urge incontinence feel an unexpected and urgent need to pass urine due to an involuntary contraction of the bladder, resulting in the uncontrollable and sudden passage of large amounts of urine.

In overflow incontinence, the bladder cannot empty because of a blockage at the bladder neck or in the urethra or because of a weak bladder muscle. The volume of urine then builds up in the bladder, causing an intermittent or continuous dribble. Urine outflow may be obstructed by a urethral stricture, an abnormal narrowing of part of the urethra, or, in men, by an enlarged prostate gland, constricting the upper part of the urethra. Weakness of the bladder muscle may be due to an obstruction, diabetes mellitus, or pelvic surgery.

In total incontinence, there is no bladder control. The condition usually results from a nervous system disorder such as dementia or spinal injury. Surgery to treat pelvic cancers can also cause incontinence by damaging nerves that supply the bladder.

What might be done?

Urodynamic studies can determine the type of incontinence. Pads to absorb urine can be worn to protect clothes. Pelvic floor exercises and physiotherapy may help to improve bladder muscle tone. Incontinence due to incomplete bladder emptying can be relieved by intermittent self-catheterization to drain the urine or permanent bladder catheterization if the person is disabled.

Posted 09.09.2010

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