Uncontrollable, passing of urine, usually due to disease or injury of the urinary tract. Damage to or disorders of the nervous system are also frequent causes.
Types and symptoms
Stress incontinence refers to the involuntary escape of urine when someone coughs, picks up a heavy objects, laughs, jumps, or runs. It occurs when the urethral sphincter muscles (which usually keep the bladder outlet closed) have been weakened and stretched. Stress incontinence is often seen in women, usually after childbirth or in those with prolapsed of the uterus or vagina. This condition leads to the loss of small amounts of urine.
In urge incontinence, also known as irritable bladder, a constant desire to pass urine (even though the bladder is not full) is accompanied by lack of ability to control the bladder as it contracts. Once urination begins, it cannot be stopped, leading to the loss of great volumes of urine. Urge incontinence is usually caused by irritability of the bladder lining. The problem can be caused by infection or inflammation. It can also arise from the presence of stones or bladder tumours; disorders affecting the nerves that supply the bladder (such as multiple sclerosis or stroke); or anxiety. In certain cases the bladder muscles are too sensitive to rising pressure within the bladder, therefore inappropriately triggering emptying.
Complete incontinence is a total lack of bladder control caused by loss of function in the urethral sphincter. It can be associated with spinal cord damage, due to injury or disease, that affects the nerves supplying the bladder.
Overflow incontinence arises in long-term urinary retention, usually due to an obstruction such as an enlarged prostate gland. The bladder is constantly full, leading to constant dripping or urine.
Incontinence caused by lack of control from the brain, frequently incurs in young children or elderly people, and also in those with learning difficulties.
A vast range of treatments is available, and the majority of affected people achieve significant improvement. If weakened pelvic muscles are the cause of stress incontinence, pelvic floor exercises can assist. Occasionally, surgery can be necessary to tighten the pelvic muscles or correct a prolapse. Collagen injections into the urethral wall, given under anaesthetic, can also be used.
If usual bladder function cannot be restored, incontinence nappies can be worn; men can wear a penile sheath leading into a tube connected to a urine bag. Certain people can avoid incontinence by means of self-catheterisation. Permanent catheterisation is needed in particular cases.