Kinds of Urinary Incontinence
If coughing, laughing, sneezing, or other movements that put pressure on the bladder cause urine leakage, there is a strong chance of a disorder called stress incontinence. Physical changes resulting from pregnancy, childbirth, and menopause often cause stress incontinence.
This type of incontinence is common in women and, in many cases, can be treated. Childbirth and other events can injure the scaffolding that helps support the bladder in women.
Pelvic floor muscles, the vagina, and ligaments support the bladder, and if these structures weaken, the bladder can move downward, pushing slightly out of the bottom of the pelvis toward the vagina. This prevents muscles that ordinarily force the urethra shut from squeezing as tightly as they should. As a result, urine can leak into the urethra during moments of physical stress.
Stress incontinence also occurs if the squeezing muscles weaken. Stress incontinence can worsen during the week before a menstrual period. At that time, lowered estrogen levels might lead to lower muscular pressure around the urethra, increasing chances of leakage. The incidence of stress incontinence increases following menopause.
The sudden loss of urine for no apparent reason after suddenly feeling the need or urge to urinate is called urge incontinence. A common cause is inappropriate bladder contractions. Abnormal nerve signals might be the cause of these spasms.
Urge incontinence can mean that the bladder empties during sleep, after drinking a small amount of water, or by touching water or hearing it running (as when washing dishes or hearing someone else taking a shower). Certain fluids and medications such as diuretics or emotional states such as anxiety can worsen this condition.
Some medical conditions, such as hyperthyroidism and uncontrolled diabetes, can also lead to or worsen urge incontinence. 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, Parkinson’s disease, Alzheimer’s disease, stroke, and injury -including injury that occurs during surgery – all can harm bladder nerves or muscles.
Overactive bladder occurs when abnormal nerves send signals to the bladder at the wrong time, causing its muscles to squeeze without warning. Voiding up to seven times a day is normal for many women, but women with overactive bladder may find that they must urinate even more frequently. The symptoms of overactive bladder include:
- Urinary frequency – bothersome urination eight or more times a day or two or more times at night
- Urinary urgency – the sudden, strong need to urinate immediately
- Urge incontinence – leakage or gushing of urine that follows a sudden, strong urge
- Nocturia – awaking at night to urinate
People with medical problems that interfere with thinking, moving, or communicating may have trouble reaching a toilet. A person with Alzheimer’s disease, for example, may not think well enough to plan a timely trip to a restroom. A person in a wheelchair may have a hard time getting to a toilet in time.
Functional incontinence is the result of these physical and medical conditions. Conditions such as arthritis often develop with age and account for some of the incontinence of elderly women in nursing homes.
Overflow incontinence is the result of the bladder not emptying properly, causing it to spill over. Weak bladder muscles or a blocked urethra can be the cause. Nerve damage from diabetes or other diseases can lead to weak bladder muscles; tumors and urinary stones can block the urethra. Fortunately, overflow incontinence is rare in women.
Other types of incontinence
Stress and urge incontinence often occur together in women. Combinations of incontinence – and this combination in particular – are sometimes referred to as mixed incontinence.
Most women don’t have pure stress or urge incontinence, and many studies show that mixed incontinence is the most common type of urine loss in women. Transient incontinence is a temporary version of incontinence. Medications, urinary tract infections, mental impairment, and restricted mobility can all trigger transient incontinence.
Severe constipation can cause transient incontinence when the impacted stool pushes against the urinary tract and obstructs outflow. A cold can trigger incontinence, which resolves once the coughing spells cease.
Read more about the treatment options for urinary incontinence available through our Continence Center program.