THEurinary incontinence gives rise to uncontrollable and involuntary urine loss, which occurs day or night. It is not a disease, but a symptom most often related to a physical disorder.

Urinary incontinence is more common with age. However, it is not just the elderly who suffer from it. In North America, it is estimated to affect globally 1 in 4 women (and from 60 years old, at least 1 in 3). Men are twice as likely to have it, for anatomical reasons.

Still too few people dare to talk to their doctor about it. However, in most cases, there are solutions to fix the problem or to control it successfully, even if the incontinence has lasted for months or even a few years.

Causes

Here are the main causes ofurinary incontinence. They vary depending on the type of incontinence (see below).

• Un weakening of the muscles of the pelvic floor (perineum). These muscles are located at the bottom of the pelvis. They are used in particular to keep the bladder in place and to control the evacuation of stool and urine.

  Pregnancies and childbirth vaginals can weaken them. The muscles can also relax with the aging and loss of physical shape.

• The bladder descent “. It only affects women and occurs when the tissues between the bladder and the vagina are so weak or stretched that they can no longer support the weight of the bladder. It then becomes more difficult to control (see diagram). Building muscle is often enough to get the bladder back in place, but sometimes surgery is needed.
• Un prostate disorders or prostate surgery (see illustration in Prostate enlargement).
• Un health problem chronic disease that affects the control of the muscles of the bladder through the nerves. For this reason, even if one wants to refrain from urinating, it is difficult or impossible to do so. Diabetes-related neuropathy, Parkinson’s disease, multiple sclerosis, or spinal cord injury may have this effect.
• Taking some pharmaceuticals (eg, antidepressants, nasal decongestants, muscle relaxants).
• A difficulty walking, preventing them from going to the toilet on time.
• Constipation with fecal impaction (compressed and hardened stools in the rectum).

Types of urinary incontinence

Urinary stress incontinence. It is the most common form of urinary incontinence in women. It is the leakage of a small amount of urine due to a increased pressure in the abdomen, therefore on the bladder, caused by physical exertion, coughing, sneezing, laughing, etc. The pelvic floor muscles must be weakened for these situations to cause urine to leak. The leak is not necessarily preceded by an urge to urinate.

In men, this type of incontinence can occur following partial or total removal of the prostate (prostatectomy) if the surgery accidentally reaches the sphincter at the bottom of the bladder and makes it less effective.

Urge urinary incontinence. This incontinence represents a quarter of female incontinence, but it can affect children and elderly men. It is also called ” overactive bladder Or “uninhibited bladder”. The simple fact of walking, thinking of urinating (by unlocking the door of the house, for example) or even hearing water running can trigger sometimes significant urine loss. Affected people therefore urinate frequently.

This type of incontinence often results from chronic health problem which affects the nervous control of the bladder. Normally, the urination control center, located in the frontal lobe of the brain, allows you to refrain from urinating even if the urge is present. It sends signals to the muscles of the bladder to prevent contractions. People in whom this region of the brain is affected (for example, as a result of a stroke, Alzheimer’s disease, or Parkinson’s disease) no longer have good control over their cravings.

Urine loss can also be triggered by the following: consumption ofalcohol, coffee, urinary tract infection, etc.

Mixed urinary incontinence. This form of urinary incontinence is associated with at least 2 forms of this disorder. The most common combination is that of stress incontinence and urge incontinence. It represents about a quarter of female urinary incontinence.

Overflow (or overflow) urinary incontinence. It results from an overflow of urine in the bladder. This can then let urine escape uncontrollably. This overflow can be explained by an obstacle to the emptying of the bladder, for example, as a result of a disorder of the prostate, the main cause of this type of incontinence in men. It may also be due to an inability of the bladder to empty due to weakness in the bladder muscle, which then has difficulty contracting (for example, due to diabetes or a neurological disease).

Functional incontinence. Certain physical or mental disorders can prevent a person from going to the bathroom on time. This incontinence is common in the elderly due to multiple mobility problems, such as osteoarthritis of the hip or knee, hip fracture, after-effects of a stroke, etc.

Total incontinence. It is an incontinence characterized by a continuous flow of urine, day and night. Affected people have no voluntary control of their bladder, which is no longer able to play its role of urine reservoir. Total urinary incontinence is most often the consequence of physical damage occurring, in particular, due to an accident or disease which affects the spinal cord, or by total or partial destruction of the sphincter which controls the exit of the blood. urine, following prostate surgery, for example.

Possible consequences and complications

Due to the taboo that reigns aroundurinary incontinence, many people hesitate to consult. They therefore deprive themselves of the help and treatment offered. Yet, when left untreated, incontinence can significantly limit physical activity and disrupt social, sexual and professional life.

Chronic urinary incontinence increases the risk ofrecurrent urinary tract infections. It can also cause redness of the skin around the genitals (up to infections and ulcers) as it creates moisture.