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.
- 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
- Urethral incompetence or obstruction
- Bladder stone
- Bladder carcinoma
2. Detrusor underactivity
- Disk compression
- Surgical damage to the nerve supply of the detrusor muscle.
- Autonomic neuropathy (e.g. diabetes, alcoholism, vitamin B12 deficiency).
- Idiopathic (common in women)
3. Urethral obstruction
- Prostatic enlargement
- Prostatic carcinoma
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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