Urinary incontinence is the involuntary loss of urine from the bladder. This has profound implications for patients quality of life including at times and places which are inconvenient, inappropriate and socially embarrassing. Stress incontinence is loss of urine during coughing or straining. Urge incontinence is the inability to maintain urinary continence in the presence of frequent and persistent urges to void. Overflow incontinence occurs when the detrusor muscle becomes flaccid and often insensitive to stretch as the bladder distends. Weakness of the sphincter mechanism eventually leads to overflow, with urine leaking out through the urethra.

Causes

Stress incontinence

Pelvic floor injury

  • Childbirth

  • Obesity

  • Prostatectomy

  • Hysterectomy

Urge incontinence

Detrusor instability

  • Constipation

  • Excess alcohol/caffeine

  • Cystitis

  • Stones

  • Prostatectomy

  • Post-radiotherapy

  • Tuberculous-cystitis

  • Interstitial nephritis

  • Tumour

Overflow incontinence

Lower motor neurone lesions

  • Diabetes

  • Sacral nerve injury (e.g. pelvic surgery)

  • Cauda equina injury

Chronic outflow obstruction

  • Prostatic enlargement

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