Dr. Cornella, a gynecologic surgeon at Mayo Clinic in Phoenix, Arizona, describes the two main reason for involuntary urine loss, stress urinary leakage and bladder overactivity. Additionally, Dr. Cornella recalls the movements that can trigger this condition.
There are two main reasons why patients lose urine – one is stress urinary leakage where the tube is weakened that drains the bladder, and the other is where the muscle of the bladder contracts. We call the latter bladder overactivity.
If you had to compare those two kinds of mechanisms, the more problematic is bladder overactivity. That increases as the patient ages and so, common symptoms would be, “I feel the urge to go to the bathroom and have dribbling on the way,” and that relates to changes in the nerves that go to the bladder over time.
As we age, we all lose nerve and muscle function and so for patients who are elderly, bladder overactivity becomes the main way that most people lose urine and it is something which may be refracted in medication in many modalities of treatment, but there are certainly ways that we can improve the patient’s leakage when they do have bladder overactivity.
For patients who have stress urinary incontinence, any pressure on the outside of the bladder would increase the tendency to lose urine. So it may be not a cough, laugh, sneeze, but it may be going from a sitting to a standing position or it may be exercising or it may be lifting, and thus the patient has immediate and non-sustained urinary leakage due to the fact that the tube that drains the bladder is weakened.