Conditions InDepth: Urinary Incontinence
Urinary incontinence is the loss of voluntary bladder control causing leakage of urine. The temporary or chronic condition has multiple mechanisms and many causes. It can occur when you are straining (lifting, sneezing, coughing), when your bladder is full, or when you have a bladder infection. Each cause has its own methods of diagnosis and its own treatment plan.
Urinary bladder function is a careful balance between pressure from the bladder to empty and resistance from the sphincter (valve) at its outlet. Pressure to empty increases suddenly when the bladder reaches a certain volume.
Sphincter resistance depends not only on the strength of the muscle but also on its position. Both forces are controlled mostly by your autonomic (automatic) nervous system, the same system that regulates body temperature, heart rate, blood pressure, digestion, and everything else your body does without you thinking about it. You do, however, have control over the sphincter and can strengthen it with exercise.
The Female Urinary System
In the United States, 20 million women have some form of urinary incontinence. It occurs daily or weekly in one quarter of women over age 60 and half of women confined to institutions. Because of anatomical differences in men and women, there is a substantial difference between the sexes in the incidence of the various types of incontinence. Because of the prostate gland, men have more problems with obstructive incontinence than with stress incontinence. Prostate surgery can occasionally cause incontinence.
Harrison’s Principles of Internal Medicine. 14th ed. McGraw-Hill; 1998.
National Association for Continence website. Available at: http://www.nafc.org/site2/index.html .
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