Incontinence Overview
Urinary control relies on the finely coordinated activities of the smooth muscle tissue of the urethra and bladder, skeletal muscle, voluntary inhibition, and the autonomic nervous system.
Urinary incontinence can result from anatomic, physiologic, or pathologic (disease) factors. Congenital and acquired disorders of muscle innervation (e.g., ALS, spina bifida, multiple sclerosis) eventually cause inadequate urinary storage or control.
Acute and temporary incontinence are commonly caused by the following:
- Childbirth
- Limited mobility
- Medication side effect
- Urinary tract infection
Chronic incontinence is commonly caused by these factors:
- Birth defects
- Bladder muscle weakness
- Blocked urethra (due to benign prostate hyperplasia, tumor, etc.)
- Brain or spinal cord injury
- Nerve disorders
- Pelvic floor muscle weakness
- Vaginal prolapse
Types of Incontinence
Of the several types of urinary incontinence, stress, urge, and mixed incontinence account for more than 90% of cases. Overflow incontinence is more common in people with disorders that affect the nerve supply originating in the upper portion of the spinal cord and older men with benign prostate hyperplasia (BPH). The primary characteristics of these types are as follows:
- Stress — urine loss during physical activity that increases abdominal pressure (e.g., coughing, sneezing, laughing)
- Urge — urine loss with urgent need to void and involuntary bladder contraction (also called detrusor instability)
- Mixed — both stress and urge incontinence
- Overflow — constant dribbling of urine; bladder never completely empties
Incidence and Prevalence
The U.S. Department of Health and Human Services reported in 1996 that approximately 13 million people in the United States suffer from urinary incontinence. The condition is far more prevalent in women than men. In the general population aged 15 to 64 years old, 10-30% of women versus 1.5-5% of men are affected. At least 50% of nursing home residents are affected. Of that number, 70% are women.
Diagnosis >>>
