Urinary incontinence is the inability of the bladder to retain urine. Incontinence occurs most often in the elderly and among women who have had children. It rarely occurs in children.
Incontinence is usually a symptom of an underlying disorder and, if treated properly, can be improved or cured. If left untreated, it can lead to bladder infection or urinary tract infection. Also, skin that is exposed to leaked urine can develop an uncomfortable rash or other disorder.
Approximately 10 million American adults are incontinent. Women are more likely to suffer from this disorder for biological reasons. Women who have multiple vaginal births experience weakening in their pelvic floor. Weakening of this group of muscles and tissues can lead to leakage. In addition, the distance from the bladder to where urine actually leaves the body is shorter in women than in men.
During normal urination, the bladder fills and then sends a message to the nerves in the spinal cord. These nerves begin the voiding reflex, or contraction of the bladder muscles that sends urine into the urethra and out of the body.
Incontinence falls into three major categories: stress incontinence, urge incontinence, and overflow incontinence. All of these can occur when normal urinary control is disrupted.
Stress incontinence is a weakening of the muscles surrounding the urethra. The muscles cannot handle an increase in bladder pressure, which usually leads to a small amount of leakage. Coughing, sneezing, laughing, and exercising can exert extra pressure on the bladder.
Urge incontinence occurs when the bladder muscle contracts inappropriately, regardless of how much urine is in the bladder. A person has little or no control over the urge to void. This is a common form of incontinence among people with illnesses involving the central nervous system, such as stroke, spinal cord injury, Alzheimer’s disease, and multiple sclerosis.
Overflow incontinence is a condition where a person’s bladder is always partially full—excess urine spills out in small amounts on a continuous basis. Patients usually do not feel the urge to urinate. Overflow incontinence is usually associated with diabetes, an enlarged prostate that blocks urine flow (in men), or a fibroid or ovarian tumor (in women).
Other causes of incontinence are: surgery on or near the urinary tract, pregnancy, childbirth, and a slipped spinal disk that presses on the nerves. Incontinence may be a side effect of medications such as diuretics, sedatives, antidepressants, and antihistamines. Consulting a doctor and switching medication may alleviate the problem.