A catalogue of incontinence
There are several kinds of urinary incontinence (UI), a term that refers to the involuntary excretion of urine at the wrong time, in the wrong place. As the Canadian Continence Foundation points out, "incontinence is not a disease. Incontinence is a symptom of something else going on in the body and should be discussed with a healthcare professional."
The most frequent forms of UI are stress, overflow and urge incontinence, though urge incontinence may be seen in combination with other types.
- Stress urinary incontinence, which affects predominantly women, refers to urine loss when you exert a force on the bladder. Almost anything can do it: a cough or a sneeze, a laugh, exercise, picking up a bag of heavy groceries – anything that causes a bearing-down sensation.
The root of the problem is a loss of pelvic floor support due to childbirth, obesity, age or congenital weakness. The neck of the bladder falls below the pelvic floor, which is a sling of muscles that holds the uterus, bladder, bowel and other organs in place. If the bladder falls below that floor, the force vectors that usually operate to close it do the opposite: They kick the door open
Following are a few other terms you may hear your doctor use:
- Decreased bladder compliance: A failure to store urine in the bladder caused by a loss of bladder wall elasticity and of bladder accommodation. This condition may result from radiation cystitis or from inflammatory bladder conditions, such as chemical cystitis, interstitial cystitis and certain neurologic bladder disorders.
- Detrusor instability: An involuntary detrusor contraction that’s not associated with any neurologic disorders. (The detrusor is a general term for any part of the body that "pushes down." Here the detrusor is a smooth muscle in the wall of the urinary bladder that contracts the bladder and expels the urine.)
- Involuntary detrusor contraction: A cause of UI that results from uncontrolled contractions of the detrusor.
- Intrinsic sphincter deficiency (ISD): A cause of stress UI in which the urethral sphincter is unable to contract and generate sufficient resistance in the bladder. ISD may be due to congenital sphincter weakness, or it may develop in the wake of a prostatectomy (radical prostate surgery), trauma or radiation therapy.