Incontinence Overview

Stress Incontinence

• Loss of urine due to increased pressure on the bladder from activities like coughing, sneezing, laughing, exercising, or lifting heavy objects.
• Occurs when the urethra becomes hypermobile, typically due to weakened pelvic floor muscles and vaginal connective tissue.
• Common in women due to pregnancy, childbirth, and obesity.
• Intrinsic sphincter deficiency can also cause stress incontinence.
• Cystocele (bulging of the bladder) can increase risk in women.
• Prostate removal is a common cause in men.
• Other causes in men can include pelvic or neurologic trauma.
• Obesity and chronic coughing can contribute to stress incontinence in both sexes.
• Congenital disorders and neurological abnormalities can lead to stress incontinence.

Urge Incontinence

• Sudden, intense urge to urinate, often leading to involuntary urine loss.
• Overactive bladder is a term often associated with urge incontinence.
• Involuntary contractions of the detrusor muscle while the bladder is filling, leaving little time for urination control.
• Frequent urination, including at night (nocturia).
• Causes can include central nervous system disorders (stroke, Parkinson's disease, multiple sclerosis).
• Muscle changes in the bladder due to nerve damage or aging can also cause urge incontinence.
• Urinary tract infections, bladder irritants (caffeine, carbonated beverages), bowel conditions (constipation), and smoking can contribute to urge incontinence.

Overflow Incontinence

• Results from an inability to empty the bladder due to detrusor underactivity or bladder outlet obstruction.
• Detrusor underactivity can be caused by aging, muscle damage, neuropathy, spinal detrusor efferent nerve disorders, or low estrogen.
• Bladder outlet obstruction is usually due to urethral obstruction by prostate enlargement or a uterine fibroid.
• Symptoms include dribbling urine and a weak urine stream.

Mixed Incontinence

• Experience symptoms of more than one type of urinary incontinence.

Functional Incontinence

• Caused by physical or mental impairments preventing timely toileting.
• Common in older adults, especially nursing home residents.
• Example: Someone with severe arthritis may not be able to undress quickly enough to prevent incontinence.

Transient Incontinence

• Temporary urinary incontinence resulting from a condition like delirium, infection, atrophic vaginitis, medication use (diuretics, sedatives), psychological factors (depression, anxiety), high urine output, restricted mobility, fecal impaction, alcohol, or caffeine.

Stress Incontinence

• Loss of urine during activities like coughing, sneezing, laughing, exercising, or lifting heavy objects.
• Occurs due to increased pressure on the bladder and urethra.
• Often caused by weakened pelvic floor muscles and vaginal connective tissue, which normally support the bladder and urethra.
• Common causes in women include pregnancy, childbirth, and obesity.
• In men, prostate removal is a significant cause.
• Other causes include pelvic or neurologic trauma, obesity, and chronic coughing.

Urge Incontinence

• Sudden, intense urge to urinate, often followed by involuntary urination.
• Frequent urination, including throughout the night.
• Caused by involuntary bladder muscle contractions.
• Contributing factors include:
  • Central nervous system disorders (stroke, Parkinson's disease, multiple sclerosis).
  • Nerve damage or muscle changes in the bladder.
  • Urinary tract infections, bladder irritants, constipation, and smoking.

Overflow Incontinence

• Difficulty emptying the bladder due to a weak bladder muscle or a blocked urethra.
• Characterized by dribbling urine and a weak urine stream.
• Causes include:
  • Detrusor underactivity: Impaired bladder muscle contraction due to aging, damage, neuropathy, or low estrogen.
  • Bladder outlet obstruction: Blocked urethra, often caused by an enlarged prostate or uterine fibroids.

Mixed Incontinence

• A combination of two or more types of urinary incontinence, for example, urge and stress incontinence.

Functional Incontinence

• Urinary incontinence due to physical or mental limitations that make it difficult to reach the toilet in time.
• Common in older adults, especially those living in nursing homes.
• Example: Individuals with severe arthritis may struggle to undress quickly enough to prevent incontinence.

Transient Incontinence

• Temporary urinary incontinence caused by a temporary condition.
• Contributing factors include:
  • Delirium, infection, atrophic vaginitis, certain medications (diuretics, sedatives), psychological factors (depression, anxiety), high urine output, restricted mobility, fecal impaction, alcohol, and caffeine.

Stress Incontinence

• Loss of urine due to increased pressure on the bladder
• Occurs when the urethra becomes hypermobile due to lack of support from pelvic floor muscles and vaginal connective tissue
• Common causes in women include pregnancy, childbirth, and obesity
• Intrinsic sphincter deficiency can also cause stress incontinence
• Cystocele (bulging of the bladder through the vaginal wall) can increase risk
• Most common cause in men is prostate removal
• Other causes in men include pelvic or neurologic trauma
• Obesity and chronic coughing can contribute in both sexes
• Congenital and neurologic disorders can also cause stress incontinence

Urge Incontinence

• Sudden, intense urge to urinate with involuntary urine loss
• Often associated with overactive bladder
• Involuntary contractions of the detrusor muscle while the bladder is filling
• Causes can include central nervous system disorders, muscle changes in the bladder, urinary tract infections, bladder irritants, bowel conditions, and smoking

Overflow Incontinence

• Urinary retention due to inability to empty the bladder
• Results from detrusor underactivity or bladder outlet obstruction
• Detrusor underactivity caused by impaired contractility due to aging, muscle damage, neuropathy, spinal detrusor efferent nerve disorders, or low estrogen
• Bladder outlet obstruction usually due to urethral obstruction, such as prostate enlargement or a uterine fibroid
• Symptoms include dribbling urine and weak urine stream

Mixed Incontinence

• Symptoms of more than one type of urinary incontinence

Functional Incontinence

• No urinary system disorders, but physical or mental impairment prevents toileting in time
• Common in older adults, especially nursing home residents
• Example: A person with severe arthritis may not be able to undress quickly enough to prevent incontinence

Transient Incontinence

• Urinary incontinence caused by a temporary condition
• Conditions include delirium, infection, atrophic vaginitis, certain medications, psychological factors, high urine output, restricted mobility, fecal impaction, alcohol, and caffeine

Stress Incontinence

• Loss of urine due to increased pressure on the bladder from activities like coughing, sneezing, laughing, exercising, or lifting heavy objects.
• Occurs when the urethra becomes hypermobile, meaning it doesn't close properly due to a lack of support from pelvic floor muscles and vaginal connective tissue.
• Common causes in women include pregnancy, childbirth, and obesity.
• In men, prostate removal is the most common cause.
• Other causes in both sexes include obesity and chronic coughing.
• Also caused by congenital disorders and neurologic disorders.

Urge Incontinence

• Sudden, intense urge to urinate that may be accompanied by involuntary loss of urine.
• Often called overactive bladder, with symptoms including frequent urination, including at night, and feeling a strong need to urinate.
• Caused by involuntary contractions of the detrusor muscle (bladder muscle) while the bladder is filling.
• Contributing factors include central nervous system disorders, nerve damage, aging, urinary tract infections, bladder irritants (e.g., caffeine, carbonated drinks), bowel conditions (e.g., constipation), and smoking.

Overflow Incontinence

• Inability to empty the bladder fully due to detrusor underactivity (weak bladder muscle) or bladder outlet obstruction.
• Detrusor underactivity can be caused by aging, muscle damage, neuropathy, spinal nerve disorders, or low estrogen.
• Bladder outlet obstruction is commonly due to an enlarged prostate or a uterine fibroid.
• Symptoms include dribbling urine and a weak urine stream.

Mixed Incontinence

• Symptoms of more than one type of urinary incontinence.

Functional Incontinence

• Due to physical or mental impairments preventing toileting in time, rather than a urinary system disorder.
• Common in older adults, especially those in nursing homes.

Transient Incontinence

• Temporary urinary incontinence caused by a temporary condition.
• Conditions include delirium, infection, medication use, psychological factors, overhydration, restricted mobility, fecal impaction, and alcohol/caffeine consumption.