The Causes of Urinary Incontinence

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urinary incontinence

Leaking urine involuntarily can be embarrassing for patients to talk about with health providers. Urinary incontinence is not a disease, it is a symptom with many causes. Fortunately, many treatments exist to help improve or even eliminate symptoms of this common medical condition which affects as many as 1 in 5 women and 1 in 10 men during their lifetime.

How Urinary Function Works

Both the brain and the bladder muscles control the function of the urinary floor. The bladder stores urine and the muscles around the bladder are normally relaxed so that it can expand. The sphincter muscle controls the flow of urine by closing and opening around the urethra which carries urine out of the body. The fullness of the bladder sends a signal to the brain to contract the bladder muscles, which opens up the sphincter.

Types of Urinary Incontinence

  • Stress Incontinence: the most common form of urinary incontinence which happens when the muscles of the pelvic floor have been weakened so that any pressure on the abdomen from activities like sneezing, bending or exercise can cause urine to leak.
  • Urge Incontinence: the main symptom is a sudden and uncontrollable urge to urinate, even if the bladder isn't full. Leakage may occur before the person can reach a toilet. As many as 30-40% of people have urge incontinence.
  • Mixed Incontinence: a term used for individuals with both stress and urge incontinence.
  • Overflow Incontinence: most common in men with prostate problems, in this type of urinary incontinence, the body makes more urine than the bladder can contain or empty. Sometimes there is a problem with the bladder not emptying fully. The symptom is frequently urinating of small amounts called "dribbling."

Causes of Urinary Incontinence

The most common cause of stress urinary incontinence is a weakening of the pelvic floor muscles which wrap around the bladder and rectum, helping regulate the flow of urine. The muscles become weak because of:

  • Childbirth: the more common occurrence of urinary incontinence in women is primarily because of childbirth. This is because the pressure on the bladder muscles during pregnancy can weaken the pelvic floor. Additionally, vaginal delivery can harm these muscles even more significantly. Having had multiple vaginal deliveries is a significant contributor to stress incontinence.
  • Menopause: the hormone changes in menopause can also cause a weakening of the pelvic floor.
  • Surgery: women who have had hysterectomies or other pelvic floor surgery and men who have had prostate cancer surgery frequently have problems with urinary incontinence afterward.
  • Prostate problems: men who have had prostate cancer surgery or other prostate problems often have an increased risk.
  • Medicines: some medications are linked to urinary incontinence and others seem to worsen the condition.
  • Obesity: Added weight can press on the bladder, meaning that stress incontinence is more common among obese individuals. Fortunately, improvement can occur with weight loss as modest as 5-10%.
  • Smoking: because smokers often cough, smoking can aggravate stress incontinence symptoms.
  • Age: people over the age of 60 often start losing muscle tone and that can include losing pelvic floor muscle strength.
  • Stressful activity: repetitive lifting or high impact sports can stress the pelvic floor muscles and damage them.
  • Other medical conditions: individuals with diabetes, high blood pressure or strokes have also been found to have more urinary incontinence. A tumor in the urinary tract or urinary stones can also cause urinary incontinence.

Urge Incontinence Causes

Urge incontinence occurs when the bladder is overactive and signals the need to urinate whether or not the bladder is full. Urge incontinence causes include:

  • Neurological disorders: conditions which cause injury to nerve signals involved in bladder control are multiple sclerosis, Parkinson's disease, brain tumors, strokes or spinal injuries.
  • Poor health: people who have many other medical problems are also at a higher risk for urge urinary incontinence.
  • Caffeine and alcohol: excess consumption of caffeine or alcohol can cause urgency to urinate.
  • Medications: some medications can cause an increase in urine production or require excess fluid intake that leads to urinary incontinence.
  • Constipation: large amounts of stool can press on the bladder, cause the bladder to not fill as it should, or cause the bladder to contract.

Urinary Incontinence Outcomes

Urinary incontinence is not hereditary and not a normal part of aging even though it is a common medical condition. Although this condition can cause considerable emotional distress and make daily routines difficult, many treatments are available to help individuals manage leakage and have either considerable ease of symptoms or sometimes complete relief. Common treatments include Kegel exercises to strengthen pelvic floor muscles, diet and lifestyle changes, devices to prevent urine flow, absorbent pads and surgery, when necessary.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of IncontinenceSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.

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