TYPES OF URINARY INCONTINENCE
The most common type of incontinence is called “stress” incontinence. This kind of stress is not the stress you feel when you are anxious or upset. The stress in stress incontinence refers to pressure that is placed on the bladder when a person coughs, sneezes, exercises, or laughs. This pressure can cause a person to leak urine if the muscles that support the bladder are weakened.
Stress incontinence is more common in women than in men. It can worsen during the week before a menstrual period because of lowered estrogen (a hormone) levels in the body. Stress incontinence is also very common during pregnancy and after childbirth. Being pregnant and the process of childbirth can put a great deal of pressure on the muscles around the bladder. The muscles can wind up quite weakened. Stress incontinence also seems to increase after menopause.
The person with urge incontinence will have a frequent, urgent need to go to the bathroom. For some people, the urge is so strong that they will not have time to get to the bathroom. Urine will leak out and they won’t be able to control it. People with urge incontinence may empty their bladder in their sleep, after drinking small amounts of liquid, or even when touching water or hearing it run.
The most common cause of urge incontinence is inappropriate squeezing (contracting) of the bladder muscles (also called pelvic floor muscles). The person has no control over the contractions.
These uncontrollable contractions can occur because of damage to the bladder nerves, to the brain and spinal cord (the central nervous system), or to the bladder muscles themselves. Some diseases, such as multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, and stroke, can harm bladder nerves or muscles. Urge incontinence can occur at any age although it is most common in men and in elderly people.
Quite often, people find they have symptoms of both stress incontinence and urge incontinence at the same time. This is called mixed incontinence.
Functional incontinence is seen in people who have problems moving, thinking, or communicating. Older people who have trouble walking may find it impossible to get to the bathroom in time. Arthritis may make it difficult for them to undo their clothing. People with certain conditions like Alzheimer’s disease may not be able to think well enough to even realize that they have to go to the bathroom. Functional incontinence is most often found in the elderly.
You may have people in your care who constantly dribble urine. Their bladders are like a container that is constantly overflowing. They go to the bathroom but then dribble for quite some time afterwards and are not able to control it. Early symptoms of this type of incontinence include trouble with starting to pass urine.
Another is an unusually slow flow of urine when they go to the bathroom.
Several conditions can cause overflow incontinence. These include weakened bladder muscles, narrowing of the urethra, tumors, constipation, and injury to the bladder or surrounding muscles. Certain conditions, such as diabetes, can cause nerve damage that weakens the bladder muscles.
Another cause of overflow incontinence is enlargement of the prostate gland in men, especially after the age of 55. The prostate gland is a fleshy organ that is wrapped around the narrow part of the bladder. If it enlarges, it can squeeze the bladder outlet until it interferes with the flow of urine out of the bladder. (Overflow incontinence is rather rare in women).
Transient incontinence is temporary. It occurs as a result of a problem or condition that will go away. The problem or condition could be an infection or a side effect of certain medications.
Nocturia is being woken up often at night by the need to go to the bathroom and pass urine. It is not really a type of incontinence, but can, however, be a warning of problems that are developing. Nocturia is more common over the age of 60. For instance, a normal pattern might be getting up to go to the bathroom once a night when you are in your sixties, twice a night in your seventies, three times a night in your eighties, and so on.
Nocturia has a number of possible causes. These include drinking a large amount of fluid before going to bed, the inability to hold a lot of urine as people get older, an enlarged prostate gland in older men, and excess fluid in the body.