Urinary Incontinence: Causes and Methods of Evaluation

By Griebling, Tomas L. | The Exceptional Parent, December 2008 | Go to article overview

Urinary Incontinence: Causes and Methods of Evaluation


Griebling, Tomas L., The Exceptional Parent


This article presents Part 3 of a multi-part series offering the most timely educational information, innovative approaches, products and technology solutions as well coping and stigma-fighting approaches available on the subject of incontinence. Below is an introduction to the types and physiology of urinary incontinence.

URINARY INCONTINENCE

Urinary incontinence, defined as the involuntary leakage of urine, is a common health problem in both adults and children. Although it occurs in males and females, overall it is most prevalent in adult women. Epidemiological studies suggest that approximately 30 percent of all adults will experience problems with chronic urinary incontinence at some point in their lives. It tends to be more common in older people; however, it should not be considered to be a normal part of the aging process. People with urinary incontinence often do not seek medical assistance either due to embarrassment or because they assume that nothing can be done to help alleviate the condition. Another common myth is that surgery is the only option for treatment.

Incontinence has been associated with other negative outcomes including loss of self-esteem, depression, and social isolation. In children, this may lead to a decrease in interaction with others and avoidance of recreational activities. Many people avoid doing the things that they normally enjoy because of the fear of urinary leakage.

Loss of urine may occur with physical activity or at other times. Some people only have problems when the bladder is quite full. Others experience more difficulty at night. It is common for many adults to have to get up at least once from sleep in order to urinate. This will also depend in part on how much fluid a person drinks in the late afternoon or evening. However, if people are getting up more often, this may indicate there is some type of problem that might respond to evaluation and treatment. This frequent need to urinate at night disrupts sleep and can lead to daytime fatigue.

CAUSES AND TYPES OF URINARY INCONTINENCE

There are several different types of urinary incontinence, and the causes of each type are different. It is important to differentiate between these because the treatments for each type of incontinence also differ, and successful therapy depends on proper diagnosis.

* Stress Incontinence

Stress incontinence is one of the most common forms of urinary incontinence, particularly in women. Urine leakage tends to occur with activities associated with an increase in the pressure in the abdomen. Examples include coughing, sneezing, laughing, or lifting. Some people with stress incontinence leak only during exercise. Anatomically, the leakage is caused either by a failure of the external sphincter muscle at the neck of the bladder to close completely, or because the urethra is hypermobile and moves out of the normal position. In either case, the resistance at the bladder outlet is lower than the pressure in the abdomen, and urinary leakage occurs. Stress incontinence is common in women who have had children

* Urge Incontinence

Urinary urgency is a condition associated with sensations of a sudden need to urinate. With urge incontinence, urine leakage occurs before the person reaches the toilet. These conditions are sometimes also called overactive bladder. This is actually the most common type of urinary incontinence seen in elderly individuals. The problem is typically caused by an overactivity of the muscles of the wall of the bladder. This leads to involuntary contractions of the bladder, which causes urine leakage. In many cases a specific cause cannot be found; however, urge incontinence is often seen with neurological disorders including multiple sclerosis, Parkinson's disease, spinal stenosis, or other injuries, and in people who have suffered a stroke.

* Overflow Incontinence

Overflow incontinence refers to a condition in which the bladder fills but does not empty efficiently. …

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