Causes of Urinary Incontinence

Although urinary incontinence is not discussed as freely as are other health conditions, it is not an uncommon problem. One of the first steps towards addressing urinary incontinence is to understand what causes it. There are several types of urinary incontinence, and each of them is associated with multiple potential causes.

Stress incontinence is one commonly-occurring bladder condition. People who leak urine when they cough, laugh, strain, or lift are incontinent because physical pressure strains the opening of the bladder and the pelvic muscles. Women are vulnerable to stress incontinence as they become older. Aging bladder muscle tissue loses some of its elasticity. The strains of pregnancy and childbirth also weaken the pelvic floor, making older mothers especially prone to having bladder accidents. Obesity can aggravate other causes of urinary incontinence associated with physical stress. 

Urgency incontinence, sometimes called overactive bladder, is also among the common causes of urinary incontinence. People who suddenly lose large volumes of urine experience uncontrolled spasms of the bladder muscles. Enlargement of the prostate gland, irritation of the lining of the bladder, or obstructions of the urethra, like kidney stones, cause this type of urinary incontinence. Excessive consumption of acidic drinks like sodas or fruit juices can inflame an already irritated bladder wall. Acid-affected bladder tissue can lead to an increase in the frequency of incontinent episodes. Neuromuscular syndromes such as multiple sclerosis, cerebral palsy, or traumatic brain injury also cause these problematic contractures of the bladder muscles. 

A look at the common causes of urinary incontinence includes attention to overflow incontinence. Some people’s urine leaks on a chronic basis, such that their bladders lose small amounts even immediately after they void. Overflow patients are unable to empty their bladders completely. Men should be aware that an enlarging prostate could contribute to overflow incontinence. Neurological problems might also result in urine overflow. Some nerve conditions can diminish a person’s sensitivity to the urge to void. Diabetic neuropathy for example leads to overflow incontinence. Patients might also be screened for obstructions of the urinary tract like stones or tumors. 

Finally, enuresis is a type of incontinence affecting older children or adults who experience involuntary urination during sleep. Bedwetting results both from increased urine production and from the inability to waken and empty the bladder. The causes of urinary incontinence during sleep include sleep disorders, seizures, excessive emotional stress, and psychological trauma. Sleep apnea interferes with the patient’s breathing, causing exhaustion and abnormal sleep patterns that can lead to enuresis. Seizure activity causes the sphincter muscles to spasm, resulting in voiding accidents. People who have brief episodes of bedwetting might be reacting instead to an acute emotional stressor, or to extreme physical fatigue that disrupts normal urinary habits. Anxiety associated with severe psychological trauma can also contribute to bedwetting. Night terrors or flashbacks might prevent patients from remaining continent during the night.

Each type of incontinence is associated with bothersome and embarrassing symptoms. But identifying the causes of urinary incontinence opens a discussion that breaks the silence.

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