Urinary incontinence refers to involuntary loss of urine, causing embarrassment and inconvenience for the patient. Causes are numerous and can be grouped into some well recognized patterns. Prostatic hyperplasia is a common cause in men while in women child birth or gynecologic procedures often lead to urinary incontinence.
- Stress Incontinence: The sphincter fails to hold urine when intra-abdominal pressure rises as in coughing or laughing. This is more common in elderly obese women. Pelvic floor weakness due to old age, child birth or after menopause is a common underlying cause.
- Urge incontinence: An urge to urinate is quickly followed by uncontrollable emptying of bladder. Motor urgency refers to incontinence due to overactive detrusor muscle. Sensory urgency refers to a hypersensitive bladder due to infection or stone.
- Overflow incontinence: This occurs in men with prostatic hyperplasia or in patients with atonic bladder. A chronically over-distended bladder (due to distal obstruction or loss of tone) overflows, especially at night when sphincter is relatively relaxed.
- Continuous incontinence: This is due to anatomic defects like birth anomalies (ectopic ureteric opening) or vesicovaginal fistula (after gynecologic surgery).