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Urinary incontinence is an inability to hold your urine
until you get to a toilet. More than 13 million people in the United States--male and female,
young and old--experience incontinence. It is often temporary, and it always results from an
underlying medical condition.
Incontinence is a symptom, not a disease in itself. It should be discussed with your physician
because it could be a symptom of a more serious underlying medical condition.
Women experience incontinence two times more often than men. Pregnancy and childbirth, menopause,
and the structure of the female urinary tract account for this difference. Mild to moderate stress incontinence and many cases of
over active bladder can be cured or greatly improved using pelvic muscle exercises and bladder
retraining.
The most common types of incontinence for women are: Stress
incontinence, Urge incontinence, Mixed incontinence.
Stress Incontinence
If muscles are too weak, you may have accidents when you cough, sneeze, laugh, or lift a heavy
object. This is called stress incontinence. Physical changes resulting from pregnancy, childbirth,
and menopause are common events that often cause stress incontinence. Even the strain of heavy
lifting or of chronic coughing can cause stress incontinence. It is the most common form of
incontinence in women and is often treatable with simple exercises called
Kegels.
Pelvic floor muscles support your bladder . If these
muscles weaken, your bladder can move downward, pushing slightly out of the bottom of the
pelvis toward the vagina. This interferes with muscles that ordinarily force the urethra shut.
As a result, urine can leak into the urethra during moments of physical stress. 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.
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Urge Incontinence: Sometimes, the bladder muscles
become hyperactive. If you have frequent, strong, sudden urges to go to the bathroom you may
have urge incontinence. Oftentimes there is very little urine in in your bladder. The most
common cause of urge incontinence is inappropriate bladder contractions. 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 someone else is taking a shower or washing
dishes).
Medical professionals describe such a bladder as "unstable," "spastic," or "over active." Your
doctor might call your condition "reflex incontinence" if it results from over active nerves
controlling the bladder.
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Mixed incontinenc: Mixed incontinence is a
combination of stress incontinence and urge incontinence symptoms. You may leak when you
cough or sneeze AND you may have uncontrollably strong urges to get to the bathroom,
oftentimes leaking before you get there.
Other Types of 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 muscles themselves. Multiple sclerosis, Parkinson's
disease, Alzheimer's disease, stroke, brain tumors, and injury--including injury that occurs
during surgery--all can harm bladder nerves or muscles.
Functional Incontinence: People with functional incontinence may have problems thinking,
moving, or communicating that prevent them from 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 be blocked from getting to a toilet in time. Conditions such as these are often
associated with age and account for some of the incontinence of elderly women in nursing homes.
Overflow Incontinence: If your bladder has become so stretched that it doesn't squeeze urine
out effectively, or if the urethra is blocked, your bladder may be full all the time. If this is
so, it may get so full that it continually leaks small amounts of urine, like water spilling over a
dam. This is called overflow incontinence. 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.
Transient Incontinence: "Transient incontinence" is a temporary version of incontinence. It
can be triggered by medications, urinary tract infections, mental impairment, restricted mobility,
and stool impaction (severe constipation), which can push against the urinary tract and obstruct
outflow.
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