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Urinary incontinence
Urinary incontinence is the involuntary leakage of urine.
Causes of urinary incontinence can be classified into those leading to
transient incontinence and those causing established incontinence.
1. Transient incontinence
- Delirium and psychiatric disturbances may lead leaking of urine involuntarily.
- Infection, which is usually accompanied by other symptoms (urgency,
dysuria).
- Atrophic urethritis or vaginitis are conditions common in postmenopausal
women (due to thinning of the lining tissue due to estrogen deficiency.
- Drugs such as
diuretics,
calcium channel blockers, some
antidepressants
and ACE
inhibitors may lead to incontinence. Alcohol is associated with
transient incontinence.
- Depression
- Excess urinary output (such as
congestive heart failure, hyperglycemia)
- Restricted mobility such as patients confined to wheelchairs.
- Stool impaction
2. Established incontinence
1. Detrusor overactivity
Neurogenic
Non-neurogenic
- Urethral incompetence or obstruction
- Cystitis
- Bladder stone
- Bladder carcinoma
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2. Detrusor underactivity
Neurogenic
- Disk compression
- Plexopathy
- Surgical damage to the nerve supply of the detrusor muscle.
- Autonomic neuropathy (e.g.
diabetes, alcoholism, vitamin B12 deficiency).
Non-neurogenic
- Idiopathic (common in women)
3. Urethral obstruction
4. Urethral incompetence
- Radical prostatectomy
- Stress urinary incontinence (SUI) types 1, 2 and 3. SUI types 1 and
2 are associated with urethral hypermobility, while SUI type 3 is associated
with urethral incompetence.
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