Incontinence

 

Stress Incontinence, also known as effort incontinence, is the loss of small amounts of urine associated with coughing, laughing, sneezing, exercising or other movements that increase pressure in the abdominal cavity, and thus on the bladder. If the pelvic floor musculature or the sphincter muscle around the urethra is too weak to resist the pressure, urine will be squeezed out. Stress incontinence may occur due to physical changes resulting from pregnancy, childbirth, menopause, prostatectomy, hormonal changes with age, tissue wear due to aging, stretching of connective tissue, and surgery. Stress incontinence is the most common form of urinary incontinence among women and is treatable.

 

Urge Incontinence is involuntary loss of urine occurring for no apparent reason while suddenly feeling the need or urge to urine. The most common cause of urge incontinence is involuntary and inappropriate detrusor muscle contractions. Urge incontinence may also be called reflex incontinence if it results from overactive nerves controlling the bladder. 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 (MS), Parkinson’s disease, Alzheimer’s disease, stroke, injuries (including the ones occurring from surgical procedures) can all harm bladder nerves or muscles. Some people experience this strong urge to urinate without the resulting urine leakage.

 

Mixed Urinary Incontinence disorder is not uncommon in the elderly female population and can sometimes be complicated by urinary retention, which makes it a treatment challenge requiring staged, multimodal treatment.

 

Functional Incontinence is involuntary urine leakage due to physical problems or congnitive difficulties. It occurs when a person recognizes the need to urine but cannot physically make it to the bathroom in time due to limited mobility. Functional incontinence may be caused by confusion, dementia, poor eyesight, poor mobility, poor dexterity, unwillingness to toilet because of depression, anxiety or anger, drunkenness or being in a situation in which it is impossible to reach a toilet.

 

Overflow Incontinence occurs when the patient’s bladder is always full so that it frequently leaks urine. Weak bladder muscles, resulting in incomplete emptying of the bladder or a blocked urethra can cause this type of incontinence. Anatomic neuropathy from diabetes or other diseases e.g. multiple sclerosis, can decrease neural signals from the bladder (allowing for overfilling) and may also decrease the expulsion of urine by the detrusor muscle (allowing for urinary retention). Furthermore, tumors and kidney stones can block the urethra, spinal cord injuries or nervous system disorders are additional causes of overflow incontinence. In men, bening prostatic hyperplasia (BPH) may also restrict the flow of urine. Overflow incontinence is rare in women, although sometimes it is caused by fibroid or ovarian tumors. Early symptoms include a hesitant or slow stream of urine during voluntary urination. Anticholinergic medications may worsen overflow incontinence.

Faecal Incontinence is the loss of regular control of the bowels. Involuntary excretion and leaking are common occurrences for those affected. Subjects relating to defecation are often socially unacceptable, thus those affected may be beset by feeling of shame and humiliation. Some do not seek medical help and instead attempt to self-manage the problem. This can lead to social withdrawal and isolation, which can turn into cases of agoraphobia. Faecal leakage is very common in elderly people. This problem is often due to intestinal disorders, which must be eliminated in the examination by a specialist. The condition may result from complications during childbirth or rectal surgery. Sometime the cause of Faecal Incontinence is malfunction of the nerves at the base of the spine that control the lower bowel. Damage of the sphincter muscles in the anus or to the nerves controlling these muscles or constipation can also cause bowel leakage. Pelvic floor weakness in another leading cause and this can also contribute to urinary incontinence. In many people, simple advice about diet, pelvic floor training, electrical stimulation, will help in the treatment of this condition, as long as there is no serious defect of the sphincter or nerve damage.

 

Temporary Incontinence or Transient Incontinence may be triggered by various types of urinary track infections, medications, immobility or serious constipation, and surgical procedures. When the underlying cause s treated, the involuntary urine leakage disappears.