Essentially, urinary incontinence happens when the muscles of the bladder controlling the flow of urine relax involuntarily. This leads to either leaking of urine or uncontrolled urinating. Urologists report that about one-quarter to one-third of Americans suffer from urinary incontinence. For some people, the condition can be mild and annoying, while for others it can be chronic and involve uncontrollable urination. Urinary incontinence is not classified as a disease. However, it can be a sign of some other medical condition.
Urinary problems such as incontinence appear to be more common among women than men.
Primary and secondary types of urinary incontinence
When we talk about primary and secondary urinary incontinence, primary means that the condition is strictly related to the bladder, while secondary suggests that there is another reason – for example, stress – that is leading to the symptoms.
To get a better understanding of the different types of incontinence, review the brief explanations below.
- Stress incontinence: This is the result of pressure on the bladder, which leads to frequent urination or leaks. It has been linked to depression, social isolation, anxiety disorders, and embarrassment. Sneezing, coughing, and laughing can trigger stress incontinence. The weakening of the urinary sphincter (which is responsible for releasing urine) causes the stress incontinence.
- Urge incontinence: Sometimes referred to as overactive bladder or spastic bladder, urge incontinence is the strong urge to urinate and/or involuntary lose urine. With this type of incontinence, the muscles begin to contract even when the bladder is nowhere full, thus intensifying the urge to urinate. Studies show that bladder cancer, bladder inflammation, bladder obstruction, enlarged prostate, bladder stones, and some autoimmune diseases can cause urge incontinence.
- Overflow incontinence: With this type of incontinence, people are not able to fully empty their bladder, which can lead to overflow and leaks. Any urine that remains in the bladder can lead to bacteria building up and result in infections. Someone with overflow problems can experience a sudden release of urine, feel like their bladder is full right after having been to the washroom, and have leaks while sleeping and difficulty going even though there is a strong urge to go. It is believed that muscle weakness or nerve damage due to injury, as well as surgery or a neurological disease can lead to overflow incontinence.
- Functional incontinence: People who have functional incontinence have a difficult time getting to the toilet. The problem could be that a person can’t get to the washroom quickly due to mobility restrictions or is slow to remove clothing. Some people with musculoskeletal problems face functional incontinence. Those with neurological problems, such as multiple sclerosis or Parkinson’s disease, may also suffer from functional incontinence. There are even situations where a person may not think clearly and, therefore, can’t get to a washroom in time. Those with dementia would fall into this category.
- Mixed incontinence: In mixed urinary incontinence cases, a person has a combination of two types of incontinence, such as stress incontinence and urge incontinence. Leaks can occur when coughing or sneezing, as well as a strong urge to urinate. In most situations, one type of incontinence is stronger than the other. The cause of mixed urinary incontinence can be a combination of stress and nerve or bladder muscle damage.
- Transient incontinence: This type of incontinence is a temporary condition that is normally caused by an illness or a medical condition. For example, a person could have transient incontinence if they are pregnant or have a urinary tract infection. Usually, the prominent symptom is leaking when laughing, coughing, or lifting anything.
- Total incontinence: Someone suffers from total incontinence when they have no control whatsoever over urine flow. Neurogenic bladder, a problem that prevents the bladder from emptying properly, is one cause. Spinal cord injuries, multiple sclerosis, and other nerve function disorders can cause total incontinence.
Treatment options to manage types of urinary incontinence
Incontinence treatments often depend on the type of urinary incontinence a person suffers from and how severe the condition is. In some situations, pelvic floor exercises called Kegel can help strengthen the urinary sphincter and thus the pelvic muscles to help prevent the urine from leaking out. There is also a technique known as bladder training. Someone who bladder-trains is aiming to bring urge under control. One way to do this is to schedule certain times for washroom breaks and stick to those times. After a while, the bladder gets accustomed to emptying at specific times and the random, frequent urges start to subside. Some urologists also suggest double-voiding, which means going to the toilet, then waiting for a couple minutes and going again.
In some instances, medications are prescribed for urinary incontinence. This can include medications that calm overactive bladder or lessen the urge sensation. Topical estrogen has also been used to help reinforce tissues in the vaginal area, which has potential to lessen symptoms. When stress incontinence is the diagnosis, sometimes antidepressants will be prescribed.
Urinary incontinence can be difficult to cope with, and for many sufferers it goes undiagnosed. People keep it a secret because they are embarrassed about the condition. It’s important that these people seek help, not only so that they can gain a better quality of life, but also to protect themselves from any complications. People with urinary incontinence have been known to experience skin problems, such as rashes and infections, due to wet or damp skin. They are also prone to urinary tract infections. Women with urinary incontinence are at risk of prolapse. This is when parts of the vagina, bladder, and urethra fall into the entrance of the vagina because of weak pelvic floor muscles.