How Does Urinary Incontinence Occur?

There are 5 Types of Urinary Incontinence:

Stress Incontinence

Stress incontinence is the involuntary urine leakage during activities that increase intraabdominal pressure (while laughing, sneezing, exercising, walking, coughing). Stress is the most frequent reason for urinary continence in women and is observed in 50-70 % of women who leak urine. The most frequent reason for stress incontinence is the weakness of pelvic floor muscles. Pelvic floor muscles sustain lower urinary tract organs.

A strong pelvic floor keeps the urethra closed until it is time to urinate. When there is pelvic floor weakness, situations that will increase intraabdominal pleasure (sneezing, coughing etc.) cause the urethra to open and leak urine. Too many deliveries, delivering big babies, vacuum assisted delivery, excess weight, familial predisposition and menopause can be counted as risk factors. Another reason for stress incontinence is the incompetence of the muscles that control bladder emptying. These muscles keep the urethra closed as the bladder swells and enables urination by getting loose when it is time to urinate. Urinary incontinence takes place during various activities (coughing, sneezing etc.) if insufficiency of these muscles, which are called sphincters, is in question

Urge Incontinence

This incontinence type, which is also called detrusor instability, is usually the contraction of the urinary bladder spontaneously due to bladder filling or other stimulations and is observed in 30% of patients. Urinary incontinence before reaching the toilet when the need for going to the toilet arises is observed in this type of incontinence very often. Unlike stress incontinence, urge incontinence arises not from a weakness in the pelvic floor but from overactive and oversensitive bladder sphincters. The reason is not known in a large majority of the patients and chronic illnesses such as previous frequent bladder infections, spinal cord trauma, severe hernia of the loins, diabetes, Parkinson disease, dementia are seen in a part of them.

Mixed Type Incontinence

Mixed type incontinence is the incontinence in which both stress incontinence and urge incontinence are seen together. Both forms of incontinence coexist in 20% of patients.

Overflow Incontinence

This type of incontinence which is also known as overflow incontinence is due to bladder overdistention and is seen in 5-10% women suffering from incontinence. When urine that exceeds the capacity accumulates in the bladder, small amounts of urinary incontinence without feeling the necessity to urinate. The woman gets the feeling that she can never empty her bladder completely. Overflow incontinence is frequently observed in some muscular diseases such as diabetes, large size pelvic operations, spinal cord injuries and multiple sclerosis. .

Sphincter Insufficiency

Sphincter insufficiency is very rare. It is as a considered as a type of stress incontinence by some doctors. It is difficult to treat and is observed usually after failing bladder correction surgeries. Sphincter insufficiency is the disorder in the part of the bladder that opens up to the urethra (urinary tract).