Bladder Control Problems (cont.)
Types of Bladder Control Problems
There are several types of urinary incontinence. Many people have more than one type. A combination of stress and urge incontinence is especially common. Stress and urge incontinence are the most common types.
- Stress incontinence: This occurs when you do anything that strains the muscles around the bladder, such as laughing, coughing, sneezing, bending, or even walking in some people. It is caused by weakness or injury to the
muscles of the pelvis or the sphincters. The underlying causes include
physical changes due to pregnancy, childbirth, or menopause. It is a frequent
type of incontinence in women.
- Urge incontinence: This is a sudden uncontrollable desire to urinate regardless of how much urine is in the bladder. It is believed to be caused by inappropriate contractions of the bladder. The term "overactive bladder" has been adopted to describe urge incontinence, detrusor instability, and hypersensitive detrusor. Urgency, frequency, and urination at night (nocturia) are common in people with this condition. This is due to disruption of signals between the bladder and the brain. Environmental cues, such as running water or
putting the key in the front door, may prompt urgency or leakage. It is a
frequent type of incontinence in both men and women.
- Mixed incontinence: This is a mixture of stress and
- Overflow incontinence: This results when you retain
urine in your bladder either because your muscle tone is weak or you have some
sort of blockage below your bladder. Symptoms include dribbling, urgency,
hesitancy, low-force urine stream, straining, and urinating only a small
amount despite a sensation of urgency. It is a frequent type of incontinence
- Neuropathic incontinence: This results from a problem affecting one or more nerves. Either the detrusor muscle overcontracts or the interior sphincter lacks the tension to hold urine
- Fistula: This is an abnormal internal
connection between organs or structures such as the bladder, ureters, or
urethra. This can cause incontinence.
- Traumatic incontinence: This is incontinence that occurs after injury to your pelvis (such as a fracture) or as a complication of
incontinence: This may occur in people born with their bladder or one or both
- Obstruction to urine flow: This may cause incontinence.
The following seem to have little or nothing to do with causing bladder control problems:
- Problems or delays in toilet training in childhood (However, some evidence links childhood voiding dysfunction with
adult voiding dysfunction, that is, incontinence.)
- Having a parent with a bladder control problem
George Lazarou, MD, FACOG
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