There are different types of urinary incontinence and each type may require a different approach.
If you experience urinary continence
When you cough,
When you laugh,
When you sneeze, then you may have “stress urinary incontinence”.
The word, “stress” here defines not your emotional state, but the physical exertion such as sneezing or coughing, which creates pressure on the abdomen.
• History of difficulty giving birth or problematic labor, giving birth to a large baby, and advanced maternal age may cause stress urinary incontinence even years after giving birth.
• In women, the aging process together with menopause can also cause this type of urinary incontinence.
• Stress urinary incontinence in men is usually seen after prostate surgery or pelvic fracture.
• In addition, serious respiratory diseases such as emphysema and cystic fibrosis, which cause frequent coughing, can also cause stress urinary incontinence.
Stress urinary incontinence develops due to weakening of bladder muscles.
Overactive bladder – Urge Urinary incontinence
Sometimes you may feel like you are stuck in the toilet even though your bladder is not full. If the urgency is followed by not being able to reach the toilet, then you may have ‘urge urinary incontinence’.
Although this urgency does not always result in urinary leakage, it can interrupt your work and social life due to the need to go to the toilet when you meet with your friends or during a business meeting:
• Urinary tract diseases caused by microbes such as cystitis in women and prostatitis in men,
• Having bladder stones,
• Benign prostate hyperplasia,
• Prostate cancer treatment,
• The presence of diseases that affect the muscle and nervous system such as Multiple Sclerosis and Parkinson’s can cause “squeezing type urinary incontinence”.
‘Urge urinary incontinence’ is caused by overactive work of the bladder muscles, in contrast to stress urinary incontinence, which is caused by weakened bladder muscles.
Note: Apart from all these reasons, for example, you may feel urinary urgency when you come home and try to open the door. Just like the involuntary mouth watering when one sees a lemon, the need to urinate, which you suppress until you get home is conditioned to arrive home and silently waits its turn. This type of urgency in front of the door to your home is not a physiological problem, it simply develops as a result of conditioning.
Mixed-type urinary incontinence
If you are experiencing signs of “stress urinary incontinence”, which develops due to the weakening of bladder muscles as well as signs of “urge urinary incontinence” caused by the overactive work of the bladder muscles, then you may have “mixed-type urinary incontinence”.
Although more common in women, men who have had prostate surgery and the frail elderly may also suffer from mixed-type urinary incontinence.
Overflow urinary incontinence
You may feel that your bladder is not fully emptied each time you urinate if your bladder opening, which should be relaxed for urine outflow, cannot relax enough after your bladder contracts. Some urine remaining in the bladder creates constant pressure on the bladder. This causes leakage of urine, leading to urinary incontinence.
This type of urinary incontinence is called “overflow urinary incontinence”.
• Narrowing of the bladder outlet due to prostate enlargement (in men),
• Uterus prolapse/sagging (in women),
• Diabetes-related damage to the nerves that control the bladder,
• Damage to nerve cells that regulate the bladder, such as spinal cord injuries
may all cause “overflow urinary incontinence”.
Functional urinary incontinence
Despite properly functioning bladder muscles and bladder, you may have difficulty in moving due to rheumatic diseases and you may therefore experience incontinence due to not being able to reach the toilet when you need. Such complaints are referred to as “functional urinary incontinence”.
• Rheumatic diseases that limit movement, which may prevent reaching the toilet,
• Nervous system health disorders such as dementia, Alzheimer’s, and stroke that prevent thinking about going to the toilet and taking action lead to “functional type incontinence”.
Reflex urinary incontinence
This type of incontinence refers to involuntary leakage of urine without any stimulation. In particular,
• Diseases that cause damage to the nervous system
• Accidents affecting the spinal cord structure
• Medical interventions that can cause nervous system side effects, such as radiotherapy, can cause this type of leak.
Temporary urinary incontinence
• If your urinary incontinence problem -which you experience due to urinary tract diseases caused by microbes such as bacteria, or medication such as diuretics that cause overwork of the bladder- resolves with the improvement of your current condition (e.g. if the problem causing urinary incontinence has responded to treatment or if you no longer need to use diuretics), then the problem you have is called “temporary urinary incontinence”.
• However, if your complaints of urinary continence persist, then you may have “permanent urinary incontinence”.
Fecal and urinary incontinence
Individuals with health problems that prevent them from thinking about going to the toilet and taking action, such as dementia, Alzheimer’s, stroke, and those who have been exposed to accidents that cause damage to nerve cells that regulate the bladder, such as spinal cord injuries may have fecal incontinence in addition to urinary incontinence.
Urinary incontinence can be taken under control and treated. Do not hesitate to ask for help from your doctor.
Reference: http://www.patienteducationcenter.org/articles/types-urinary-incontinence/. Accessed: April 2017.
Akın S. Yaşlılarda üriner inkontinans. Kontinans ve Nöroüroloji Bülteni 2015;2:49-54
Norton C. Conservative and Pharmacological Management of Faecal Incontinence in Adults. Ch 24. Committee 18. https://www.ics.org/Publications/ici_3/v2.pdf/chap24.pdf (Ch24, Committee 18. Accessed: April 2017.
Obokhare I. Fecal Impaction: A Cause for Concern? Clin Colon Rectal Surg 2012;25:53–58.