There are six types of urinary incontinence; the clinical presentation and causes vary with each type:
- Stress incontinence: Urine leaks involuntarily when there is increased pressure exerted on the abdomen and bladder while straining, exercising, coughing, sneezing, laughing, or lifting heavy objects.
- Overflow incontinence: Patients have frequent and/or constant dribbling of urine because the bladder doesn't empty completely. This may be seen in patients with spinal cord injury, nerve damage, prostate problems, etc.
- Urge incontinence: There is a sudden, intense urge to urinate followed by an involuntary loss of urine. Patients urinate frequently, including throughout the night, disturbing sleep. Urge incontinence may be caused by urinary tract infections or neurologic disorders.
- Functional incontinence: A physical or mental condition that prevents patients from being able to make it to the toilet in time, for example, severe debilitating arthritis or psychiatric disorders such as schizophrenia.
- Total incontinence: Patients always have continuous leakage of urine. The most common cause is an abnormal communication between the bladder and vagina that is called vesicovaginal fistula.
- Mixed incontinence: Patients suffer from more than one type of urinary incontinence.
What is urinary incontinence?
Urinary incontinence is loss of bladder control. The severity ranges from occasionally leaking urine while straining, coughing, or sneezing or having a frequent urge to urinate that occurs suddenly. Some people may only experience occasional and minor leaks of urine, whereas others may lose small-to-moderate amounts of urine frequently. Urinary incontinence can affect daily activities and quality of life; hence, it requires appropriate treatment. Treatment involves medical management and lifestyle changes.
What causes urinary incontinence?
Urinary incontinence isn't a disease; it's a symptom of another underlying condition causing loss of bladder control.
Causes of temporary urinary incontinence: Certain foods, drinks, and medications can stimulate the bladder, increase fluid excretion, and increase the volume of urine. They include:
- Excessive caffeine
- Alcohol
- Aerated drinks
- Artificial sweeteners
- High dose of vitamin C
- Chocolate
- Foods that are high in spice, sugar, or acid, for example, citrus fruits
- Medications to treat heart conditions and regulate blood pressure, sedatives, muscle relaxants, and diuretics
Urinary incontinence due to treatable medical conditions:
Causes of persistent urinary incontinence:
- Pregnancy: Increased weight and size of the fetus and an expanding uterus can increase pressure in the uterus causing incontinence.
- Childbirth: Vaginal delivery can damage the nerves of the bladder and weaken muscles of the pelvic floor that are necessary for bladder control.
- Aging: Aging causes weakening of the bladder muscle and reduces the bladder's urine storage capacity. Involuntary bladder contractions may occur during old age.
- Menopause: After menopause, in women, there is a decrease in the reproductive hormone causing thinning of the lining of the bladder and urethra that can lead to incontinence.
- Hysterectomy (uterus removal surgery): The bladder and uterus are supported by many of the same muscles and ligaments. A hysterectomy can cause weakening of the pelvic floor muscles, leading to incontinence.
- Enlarged prostate: Enlargement of the prostate gland, benign or cancerous, can cause incontinence.
- Obstruction in the urinary tract: A tumor or stones in any part of the urinary tract can block the normal urinary flow and can lead to overflow incontinence.
- Neurological disorders: Nerve damage due to neurological disorders such as multiple sclerosis, Parkinson's disease, brain tumors, a stroke, a brain tumor, and a brain or spinal injury can damage the nerves that affect bladder control.
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