Urinary Incontinence in Women (cont.)
What are the types of incontinence? What are causes and symptoms of urinary incontinence in women?
Stress incontinence
If coughing,
laughing, sneezing, or other movements that put pressure on the bladder cause
you to leak urine, you may have stress incontinence. Physical changes resulting
from pregnancy, childbirth, and menopause often cause stress incontinence. This
type of incontinence is common in women and, in many cases, can be treated.
Childbirth and other events can injure the scaffolding that helps support the
bladder in women. Pelvic floor muscles, the vagina, and ligaments support your
bladder (see figure 2). If these structures weaken, your bladder can move
downward, pushing slightly out of the bottom of the pelvis toward the vagina.
This prevents muscles that ordinarily force the urethra shut from squeezing as
tightly as they should. As a result, urine can leak into the urethra during
moments of physical stress. Stress incontinence also occurs if the squeezing
muscles weaken.
 |
| Figure 2. Side view of female pelvic muscles. |
Stress incontinence can worsen during the week before your menstrual period.
At that time, lowered estrogen levels might lead to lower muscular pressure
around the urethra, increasing chances of leakage. The incidence of stress
incontinence increases following menopause.
Urge incontinence
If you lose urine for no apparent reason after suddenly
feeling the need or urge to urinate, you may have urge incontinence. A common
cause of urge incontinence is inappropriate bladder contractions. Abnormal nerve
signals might be the cause of these bladder spasms.
Urge incontinence can mean that your bladder empties during sleep, after
drinking a small amount of water, or when you touch water or hear it running (as
when washing dishes or hearing someone else taking a shower). Certain fluids and
medications such as diuretics or emotional states such as anxiety can worsen
this condition. Some medical conditions, such as hyperthyroidism and
uncontrolled diabetes, can also lead to or worsen urge incontinence.
Involuntary actions of bladder muscles can occur because of damage to the
nerves of the bladder, to the nervous system (spinal cord and brain), or to the
muscles themselves. Multiple sclerosis, Parkinson's disease, Alzheimer's
disease, stroke, and injury -- including injury that occurs during surgery -- all can
harm bladder nerves or muscles.
Overactive bladder
Overactive bladder occurs when abnormal nerves send
signals to the bladder at the wrong time, causing its muscles to squeeze without
warning. Voiding up to seven times a day is normal for many women, but women
with overactive bladder may find that they must urinate even more frequently.
Specifically, the symptoms of overactive bladder include
- urinary frequency -- bothersome urination eight or more times a day or two or
more times at night
- urinary urgency -- the sudden, strong need to urinate
immediately
- urge incontinence -- leakage or gushing of urine that follows a sudden,
strong urge
- nocturia -- awaking at night to urinate
Functional incontinence
People
with medical problems that interfere with thinking, moving, or communicating may
have trouble reaching a toilet. A person with Alzheimer's disease, for example,
may not think well enough to plan a timely trip to a restroom. A person in a
wheelchair may have a hard time getting to a toilet in time. Functional
incontinence is the result of these physical and medical conditions. Conditions
such as arthritis often develop with age and account for some of the
incontinence of elderly women in nursing homes.
Overflow incontinence
Overflow incontinence happens when the bladder doesn't
empty properly, causing it to spill over. Your doctor can check for this
problem. Weak bladder muscles or a blocked urethra can cause this type of
incontinence. Nerve damage from diabetes or other diseases can lead to weak
bladder muscles; tumors and urinary stones can block the urethra. Overflow
incontinence is rare in women.
Other types of incontinence
Stress and urge incontinence often occur together
in women. Combinations of incontinence -- and this combination in particular -- are
sometimes referred to as mixed incontinence. Most women don't have pure stress
or urge incontinence, and many studies show that mixed incontinence is the most
common type of urine loss in women.
Transient incontinence is a temporary version of incontinence. Medications,
urinary tract infections, mental impairment, and restricted mobility can all
trigger transient incontinence. Severe constipation can cause transient
incontinence when the impacted stool pushes against the urinary tract and
obstructs outflow. A cold can trigger incontinence, which resolves once the
coughing spells cease.
The types of urinary incontinence
| Stress |
Leakage of small amounts of urine during physical movement
(coughing, sneezing, exercising). |
| Urge |
Leakage of large amounts of urine at unexpected times, including
during sleep. |
| Overactive bladder |
Urinary frequency and urgency, with or without urge incontinence. |
| Functional |
Untimely urination because of physical disability, external
obstacles, or problems in thinking or communicating that prevent a
person from reaching a toilet. |
| Overflow |
Unexpected leakage of small amounts of urine because of a full
bladder. |
| Mixed |
Usually the occurrence of stress and urge incontinence together. |
| Transient |
Leakage that occurs temporarily because of a situation that will pass
(infection, taking a new medication, colds with coughing). |
Next: How is urinary incontinence diagnosed? »
- Urinalysis - Learn about the urinalysis test. Diseases and conditions such as urinary tract or kidney infection, kidney stones, kidney failure, diabetes, or high blood pressure can be diagnosed or monitored.
- Pregnancy (Stages - Trimesters of Pregnancy) - Learn what to expect during the three phases of pregnancy (1st, 2nd, 3rd trimester). Find out what changes in your body to expect, and how your baby will develop week by week.
- Ultrasound - Learn an ultrasound procedure, and conditions and diseases it assists in diagnosing and screening like tumors, cysts, heart conditions and more.
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