Loss of bladder control is referred to as urinary incontinence. In United States alone, more than thirteen million people suffer from this inability to hold or control urine. These people have trouble controlling their urination so much so that even when they cough or sneeze, they feel the urgent and sudden need to go to the toilet to urinate. Urinary incontinence can occur among male and female, old and young. Learn more about the causes for urinary incontinence and stress urinary incontinence.
How does urinary incontinence occur?
During urination, the muscles in the wall of the urinary bladder contract. This forces the urine out of the bladder and into the urethra. Simultaneously, the sphincter muscles surrounding the urethra relax, letting urine pass out of the body. Urinary incontinence occurs if the bladder muscles suddenly contract or muscles surrounding the urethra suddenly relax.
Urinary incontinence in women
Women experience urinary incontinence twice as often as men. Various factors like pregnancy and childbirth, menopause and the structure of the female urinary tract account for this difference. Urinary incontinence is noticed much more among older than younger women. Incontinence occurs in women usually because of the problems with muscles that help to hold or release urine.
Types of urinary incontinence in women
Stress incontinence: If a woman suffers urinary incontinence even during coughing, sneezing or other movements, it is likely due to stress incontinence. Physical changes resulting from pregnancy, childbirth, and menopause often cause stress incontinence. This is the commonest cause for incontinence in women and is treatable.
Urge incontinence: Here one loses urine even while suddenly feeling the urge to urinate. The common cause of urge incontinence is due to inappropriate bladder contractions. Urge incontinence is also referred to as unstable or overactive incontinence. This condition is also called 'reflex incontinence'. This is the result of overactive nerves controlling the bladder.
Functional incontinence: People with problems thinking, moving or communicating that prevent them from reaching a toilet suffer from functional incontinence. For example, a person with Alzheimer's disease may not think well enough to plan to reach the toilet well on time.
Elderly women in nursing homes or a patient in wheel chair may be blocked from getting to a toilet in time. Functional incontinence is often associated with age.In women, the stress and urge incontinence occur together most of the times.
Overflow incontinence: When the bladder is so full that it frequently leaks urine, it is overflow incontinence. Weak bladder muscles or a blocked urethra causes this type of incontinence.
Transient incontinence is temporary and triggered by medications, urinary tract infections, mental impairment and restricted mobility and stool impaction, which push against the urinary tract and obstruct over flow.
Reflex incontinence: This type of incontinence occurs among people with injury to the nervous system such as paralysis from spinal cord injury that affects the nerves that run to the bladder. This type of people experience urine loss without any sensation or warning at all.
Total incontinence: Continuous leak of urine, day and night or periodic large volumes of urine accompanied by uncontrollable leaking is called total incontinence. Anatomical defect can cause this type of incontinence. Spinal cord injury or injury to the urinary system from surgery can cause total incontinence.
Nocturnal enuresis: Nighttime bed-wetting is medically termed as nocturnal enuresis. Young boys who are otherwise toilet trained wet their beds in the night for a range of reasons. Sometimes adults can also lose control of their bladder at night due to excessive alcohol or medications. Aging is also likely to cause difficulty in storing urine at night because of an abnormally high production of urine at night.
Causes of persistent urinary incontinence in women
Pregnancy and childbirth: As indicated earlier, pregnant woman experience stress incontinence because of hormonal changes and increased weight of an enlarged uterus. The stress of childbirth also weakens the pelvic floor muscles and the ring of muscles that surround the urethra. Urine escapes past the weakened muscles whenever pressure is placed in your bladder.
Hysterectomy: In woman the bladder and uterus lie close to each other. They are both supported by the same muscles and ligaments. Any surgery like hysterectomy runs the risk of damaging the muscles or nerves of the urinary tract which can lead to incontinence.
Menopause: After menopause a woman's body produces less of hormone estrogen. This drop in estrogen can contribute to incontinence in women.
Cystitis: A chronic condition called interstitial cystitis usually affects women more often than men.
Causes of persistent urinary incontinence in men
Prostatitis can sometimes lead to incontinence. Enlarged prostrate in older men, a condition known as benign prostatic hyperplasia can cause constriction of the urethra and block the flow of urine. Prostrate cancer, which is untreated in men, is the cause of incontinence. Urinary incontinence is also a side effect of treatments like surgery or radiation for prostrate cancer. Cancer of the bladder causes urinary urgency and burning with urination.
Diagnosis of urinary incontinence
To evaluate the capacity of the bladder and the residual urine for evidence of poorly functioning bladder muscles, the doctor asks the patient to consume plenty of water and other fluids and urinate into a measuring pan. The doctor also recommends some of the following tests: