Some Mechanisms of Incontinence
Some Mechanisms of Incontinence
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Mechanism |
Examples |
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Weakness of the urinary sphincter or pelvic muscles (bladder outlet incompetence) |
Atrophic urethritis, vaginitis, or both Drugs Pelvic muscle weakness (for example, caused by having had several vaginal deliveries or pelvic surgery) Prostate surgery |
|
Blockage (bladder outlet obstruction) |
Prostate enlargement (benign prostatic hyperplasia) or cancer Drugs |
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Overactivity of bladder wall muscles (overactive bladder) |
Disorders that can affect brain centers that control urination (such as stroke, dementia, or multiple sclerosis) Cervical spondylosis or spinal cord dysfunction (which can put pressure on the spinal cord and thus impair bladder function) Bladder outlet obstruction |
|
Underactivity of bladder wall muscles |
Nerve damage (for example, by herniated disks, other spinal cord disorders, surgery, tumors, injury, diabetes, or alcohol use disorder) Drugs Longstanding bladder outlet obstruction In women, often no identifiable cause |
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Poor coordination of the bladder wall with the sphincter muscles |
Damage to spinal cord or brain nerve pathways to the bladder |
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Functional problems |
Dementia Depression Psychoactive drugs that can decrease awareness of the need to urinate (for example, antipsychotic drugs, benzodiazepines, drugs that cause drowsiness such as sedatives and sleep aids, or tricyclic antidepressants) Restricted mobility (for example, caused by injury, weakness, restraints, stroke, other neurologic disorders, or musculoskeletal disorders) Situational limitations (such as not having a toilet nearby or traveling) |
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Increase in the volume of urine |
Disorders such as diabetes mellitus or diabetes insipidus Use of diuretics (usually furosemide, bumetanide, or theophylline, but not thiazide diuretics) Excessive intake of caffeinated beverages (such as coffee, tea, cola, or some other soft drinks) or alcohol |