The causes of incontinence
Urinary incontinence is something many people experience. It involves involuntary contractions of the bladder, causing urine to to leak out.
It’s not a pleasant experience to live with. Incontinence affects both genders, though not equally: it’s more common for women than men.
There are several different types of urinary incontinence, and understanding the source of it will be helpful in progressing with treatment with your doctor.
Urge incontinence
When a person experiences urge incontinence, they have a very sudden compulsion to go to the toilet, but then quickly and involuntarily have a loss of urine. This kind of incontinence can be caused by minor infections, or sometimes more serious diseases like diabetes. It can also be because of muscle damage or abnormalities in the nerve cells that trigger spasm.
Stress incontinence
This is the most common type of incontinence women experience, often owing to changes to their pelvic floor or other ligaments during pregnancy and childbirth, and loss of estrogen during menopause. Stress incontinence is typified by a (usually small) urine leak when pressure is placed on your bladder, which can happen when you exercise, lift something, cough, sneeze, laugh or cry.
Overflow incontinence
If you find a dribbling effect happening to you regularly, this is called overflow incontinence. It happens because the bladder did not completely empty itself the last time you used the toilet. Sometimes, particularly in men, this is because you don’t wait long enough and finish urinating too quickly.
Functional incontinence
This form of incontinence is where you can’t physically reach the toilet, unzip and control your urination in time. This can be for physical or psychological reasons, or because of a disease such as Alzheimer’s or Parkinson’s, and is an often-encountered side effect for many people.
Transient and total incontinence
Transient incontinence is a temporary loss of bladder control caused by a medical condition, or the treatment of a medical condition. For example, transient incontinence can follow constipation or diarrhoea, be present when you’re recovering from surgery, or accompany different types of medications.
When you have a complete loss of control this is called total incontinence. It’s often the result of anatomic abnormalities or a serious injury.
It’s also possible to experience incontinence in a combination of the above forms. Needless to say, living with this condition can seriously affect one’s quality of life. It can make work and social occasions difficult and cause distressing anxiety about going to new places where you don’t know how accessible the restrooms will be.
It’s also importance to realise that urinary continence is not a disease. It’s a symptom.
For example, UTIs, or urinary tract infections, are extremely common and easily treatable. Often the cause of incontinence, they are infections that irritate your bladder, and sometimes come with a burning sensation when you urinate, blood, dark or cloudy urine, and a pungent smell.
One in two women will get at least one UTI in their lifetime, while for men it’s one in 20. Ninety per cent of UTIs are caused by the E coli bacteria, and a course of targeted antibiotics can clear it up.
Women’s incontinence, as mentioned, is common and natural with the various stages of childbirth, menopause and general ageing. The bladder muscle’s lining and the health of your urethra can see tissue deterioration because of both physical stress and hormonal changes.
For men, incontinence can be caused with ageing by benign prostatic hyperplasia, which is the result of an enlarged prostate, or prostate cancer (and the treatment of it).
Being overweight also increases pressure on your bladder and can be a factor of anyone’s incontinence, as does smoking. It can also be caused by a urinary obstruction, such as a tumour or stones in your urinary tract.
Once the cause of incontinence is discovered by your doctor, she or he may recommend a range of different treatments. They can include behavioural changes (for example, bladder and pelvic wall training, known as Kegel exercises for women), scheduling of toilet visits, fluid/diet management and the wearing of shielded underwear.
Several medications can also help treat incontinence, the next line of treatment can be an interventional therapy such as chemical injection of a substance like a bulking material or Botox, and several surgeries are considered a last measure. ❚ Lee Suckling has a master’s degree specialising in personalhealth reporting.