Incontinence

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Incontinence (in-CONT-ti-nunce), or loss of bladder or bowel control, is a symptom - not a
disease in itself. A broad range of conditions and disorders can cause incontinence, including
birth defects, pelvic surgery, injuries to the pelvic region or to the spinal cord, neurological
diseases, multiple sclerosis, poliomyelitis, infection, and degenerative changes associated with
aging. It can also occur as a result of pregnancy or childbirth.

Incontinence is a problem of the urinary system, which is composed of two kidneys, two
ureters, a bladder, and a urethra. The kidneys remove waste products from the blood and
continuously produce urine. The muscular, tube-like ureters move urine from the kidneys to
the bladder, where it is stored until it flows out of the body through the tube-like urethra. A
circular muscle, called the sphincter, controls the activity of the urethra. It is not a part of the
urinary system but can play a role in incontinence. Normally, the bladder stores the urine that
is continually produced by the kidneys until it is convenient to urinate, but when any part of
the urinary system malfunctions, incontinence can result.

Incontinence occurs in children and young adults, but the largest number affected is the
elderly. Fifty percent or more of elderly persons living at home or in long-term care facilities
are incontinent. Sufferers may experience emotional as well as physical discomfort. Many
people affected by loss of bladder or bowel control isolate themselves for fear of ridicule and
lose self-esteem. Adults often find employment impossible.

Types of Incontinence

There are five basic types of incontinence:

Stress incontinence occurs when pelvic muscles have been damaged, causing the bladder to
leak during exercise, coughing, sneezing, laughing, or any body movement which puts
pressure on the bladder.

Urge incontinence, the urgent need to pass urine and the inability to get to a toilet in time,
occurs when nerve passages along the pathway from the bladder to the brain are damaged,
causing a sudden bladder contraction that cannot be consciously inhibited.

Overflow incontinence refers to leakage that occurs when the quantity of urine produced
exceeds the bladder's holding capacity.

Reflex incontinence, the loss of urine when the person is unaware of the need to urinate, may
result from an abnormal opening between the bladder and another structure, or from a leak
in the bladder, urethra, or ureter.

Incontinence from surgery follows such operations as hysterectomies, caesarean sections,
prostatectomies, lower intestinal surgery, or rectal surgery.

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