Urinary incontinence is a term given to involuntary leakage of urine. Disease impacts the quality of life of a person and is a distressing situation. Urinary incontinence generally results secondary to a underlying medical condition which is often treatable.

 

If there is problem with stools the condition is known as fecal incontinence. Continence and micturition is due to balanced activity of detrussor muscle and urethral closure. Urethral pressure is normally more than bladder pressure which results in residual urine in the bladder. Normal voiding is due to changes in urethral and bladder pressure.

Types of Incontinence

• Stress incontinence - Stress urinary incontinence is due to insufficient strength of the pelvic floor muscles. It is also known as effort incontinence. It results in loss of small volume of urine along with coughing, laughing, sneezing, exercising and any other movement that can lead to increase in intraabdominal pressure which further increases the pressure on the urinary bladder. Stress incontinence is common finding in men who had undergone prostatectomy. It is a commonest form of incontinence in men. In females stress due to pregnancy, childbirth, and menopause can lead to incontinence. Low estrogen can cause low muscular pressure which leads to increased leakage. Stress incontinence is treatable condition. No laboratory abnormality is generally encountered in such cases.

• Urge incontinence - Urge incontinence is the term given to a condition in which there is involuntary loss of urine along with sudden feeling or urge to urinate. The commonest cause of urge incontinence is involuntary and inappropriate detrussor muscle contractions resulting from local or surrounding infection, inflammation or irritation of the bladder and defective CNS inhibitory response. Urinary bladder in this condition is described as overactive and spastic. It is also known as reflex incontinence as it may be due to hyperactivity of the nerves controlling the bladder. It usually occurs during sleep, after drinking a small amount of water. It may be due to the damage in the nervous system from control centers in the brain to the innervations in the bladder due to various diseases like alzhiemers and stroke etc.

• Functional incontinence - In this type of incontinence a person can feel the need to urinate, but he is not able to hold it till he reaches the bathroom in time due to limited mobility. The loss of urine in such cases may be large. The conditions which can lead functional incontinence are confusion, dementia, poor eyesight, poor mobility, poor dexterity, unwillingness to toilet because of depression, anxiety or anger, or being in a situation in which it is impossible to reach a toilet. Usually the patients with functional disorder have some or the other problem in either thinking , moving or communicating regarding the urge to go to the toilet for urination or defecation like a person suffering from the Alzhiemers diseases etc.

• Overflow incontinence - Some people cannot stop constantly dribbling, or in other words they continue to dribble for some time after they have passed urine like the bladder is continuously overflowing hence given the general term overflow incontinence. Overflow incontinence occurs only when the person’s urinary bladder is always full so that it frequently leaks urine. In various conditions like Weak urinary bladder muscles or detrussor muscles which results in incomplete emptying of the bladder, blocked urethra can lead to this type of incontinence.

• Structural incontinence - In some individuals some structural problems can cause incontinence, these are generally diagnosed in childhood, like an ectopic ureter.

• Bedwetting or Enuresis - Bedwetting is type of incontinence while a patient is asleep. It is normal seen in young children.

• Mixed incontinence - A combination of stress and urge incontinence is known as mixed incontinence.

• Transient incontinence - If a incontinence is due to some medications, urinary tract infection or due to some other factors it is known as transient incontinence