Bladder Matters

Types of incontinence

  • Stress Incontinence - Stress incontinence (SI) is the most common type of incontinence, accounting for 50% of women experiencing incontinence. SI occurs when pressure in the abdomen is greater than the pressure needed to keep the urethra closed. It is due to weakening of the bladder neck muscles and tissues (the structures which surround the urethra) which can happen after childbirth, around the time of the menopause or in some women they may just have weak tissues, thereby allowing urine to leak out involuntarily. Leakage happens when extra pressure is exerted on the bladder neck structures through coughing, sneezing, laughing or exercising, losing small amounts of urine at any one time. The leakage of stress incontinence is often managed by wearing pads. Because of the effect on the bladder neck muscles of childbirth, women of all ages can develop stress incontinence but the problems often increase around the time of the menopause and thereafter.

  • Urge Incontinence - Urge incontinence can occur as part of the Overactive Bladder syndrome. The detrusor muscle of the bladder can become overactive, expelling the bladder contents randomly, causing the need to pass urine more than eight times during the day (frequency), and at least twice during the night (nocturia). The need to pass urine can be extremely strong (urgency) and if the toilet cannot be reached in time, “urge incontinence” may occur, whereby small or large quantities of urine can be lost involuntarily. Wearing pads is often not enough to cope with the large amounts of urine and frequent changes of clothes may be required. Activities are often planned around the availability of toilets and some women rarely leave the house. Urge incontinence occurs more often after the menopause.

  • Mixed Incontinence - Mixed incontinence occurs when there is a combination of the conditions of stress incontinence and urge incontinence. Care must be taken to establish which are the predominant symptoms so that appropriate advice and treatment can be given.

  • True Incontinence - True incontinence may occur from birth, usually presenting in childhood when potty training becomes even more difficult than usual and is due to congenital abnormalities of the anatomy. True incontinence can also occur in women who develop a fistula (abnormal channel between the bladder and vagina) as a result of severe injury. Birth induced fistulae are rare in the UK but sadly still occur in developing countries.

  • Neurogenic Incontinence - Neurogenic incontinence can occur in association with conditions such as diabetes, Multiple Sclerosis or Parkinson’s disease when nerve control is affected.