Urinary Incontinence

Many women leak small amounts of urine from time to time. Leakage of urine can happen with certain movements, during pregnancy, or during other stress, such as coughing. Some women find that they lose urine when they hear the sound of running water or when they have their hands in water. Others find that, at times, they feel the urge to urinate and are unable to control it. When leakage of urine becomes frequent or severe enough to become a social or hygiene problem, it is called urinary incontinence.

Normal Voiding

The urinary tract is made up of kidneys, which produce urine; tubes called ureters that carry urine to the bladder, a saclike, musclar organ, where it is stored; and the urethra, a small, muscular tube about 2 inches long that carries urine from the bladder to the outside of the body. Normal urination, or voiding, occurs when a woman is able to empty her bladder whenever she has a natural desire to do so. In normal voiding, the muscles around the urethra relax, the bladder contracts, and urine flows from the bladder to the uerthra and out the body. When the bladder is almost empty, the muscles around the uretha contract, the bladder relaxes, and the stream of urine stops flowing.

Types of Incontinence

There are three types of incontinence: urge, stress, and overflow. The most common type of is urge incontinence. It is due to the detrusor muscle--the muscle wall of the bladder-- being overactive. This leads to loss of leakage of urine. Stress incontinence occurs when the pressure inside the bladder, which moves urine out, is greater than the pressure in the urethra, which keeps urine in. It causes involuntary loss of urine during coughing, laughing, sneezing, or physical activity. Its most important cause is the weakening of the tissue that surround and support the urethra and bladder. In overflow incontinence, the bladder fails to empty during voiding. This results in a steady leakage of small amounts of urine. Overflow incontinence is less common than urge incontinence and is due to the detrusor muscle being under active.

Symptoms

Women who have urinary incontinence may leak urine often. They may have to wear a pad to keep from wetting their clothes. Some women with incontinence feel such a strong desire to urinate that they cannot control it. This results in a loss of urine. A woman with urinary incontinence may also have other symptoms: Urgency: A strong desire to urinate, whether or not the bladder is full. This often occurs along with pelvic discomfort or pressure, as well as the fear of leakage or fear of pain. Frequency: Urinating more than every 2 hours or more than 7 times a day. Nocturia: The need to urinate two or more times during hours of sleep. Dysuria: Painful urination Enuresis: Bed-wetting or wetting while sleeping.

Causes

There are many possible causes of urinary incontinence. These include infection, damage to organs, and muscular disorders.

Urinary Tract Infection

Urinary incontinence may be due to an infection of the urinary tract. Often such an infection occurs along with pain, frequency, and blood in the urine. Infections of the bladder (cystitis) and of the urethra (urethritis) are very common in women.

Pelvic Support Problems

Pelvic support problems happen when the tissues that support the pelvic organs are stretched and damaged. This allows the organs that they support to sag out of place. If the tissues that normally support the urethra, bladder, uterus, and rectum are weakened, these organs may drop and lead to urinary incontinence or difficulty in passing urine.

Urinary Uract Abnormalities

Fistula are abnormal openings between the urinary tract and the vagina. these openings can allow urine to leak out through the vagina. Fistulas may result from pelvic surgery, childbirth, radiation treatment, or advanced cancer of the pelvis. Urinary incontinence can also be caused by a urethral diverticulum, a small pocket that bulges out of the wall of the urethra. Utine can collect in this pocket and then spill out later. Abnormal growths in the urinary tract can also cause incontinence. Sometimes, a small bladder size may cause problems as well.

Neuromuscular Disorders

Neuromuscular disorders are problems with the nerves that control the function of the bladder and urethra. Bladder spasms - uncontrolled contractions - may occur. If the nerves do not control the contractions of the bladder muscle, the bladder may expel urine. The bladder may also become too full, and urine may leak. Most of the time it is not known why the nerves lose control of the bladder muscle. It could be linked to other medical conditions, such as diabetes.