Neurological Disorders and Incontinence
Each year over 600,000 people are diagnosed with a neurological condition. A neurological disorder can prevent you from participating in daily activities for a short period of time, or leave you completely disabled and in need of assistance 24/7. Neurological conditions can also severely impact the development of pelvic floor disorders. Read on to learn more.
What is a Neurological Disorder?
Neurological disorders are diseases of the brain, spine, and the nerves that connect them. They can develop suddenly, or gradually over your lifetime. There are over 10 million people in the UK who live with a neurological condition which has a significant impact on their lives.
Approximately 350,000 people who suffer from neurological conditions need help for most of their daily activities, and over one million people are disabled by their condition.
Neurological conditions can affect people of all ages and at any time. There is an increased prevalence of neurological disorders in older people, and this is likely to rise due to improved longevity.
People who suffer from neurological conditions experience different levels of difficulty, ranging from feeling weak for a period of time, to requiring assistance for most everyday tasks.
The most common neurological disorders include:
- Dementia - 700,000 people are affected by dementia in the UK.
- Epilepsy - Around 300,000 people suffer from epilepsy in the UK.
- Motor Neurone Disease - Every 7 in 100,000 people in the UK suffer from motor neurone disease.
- Multiple Sclerosis - 85,000 people in the UK suffer from multiple sclerosis.
- Parkinson's Disease - Over 120,000 people suffer from Parkinson's disease in the UK.
- Stroke - 500 per 100,000 people suffer from strokes in the UK.
There are over 600 types of neurological conditions, which are categorised into:
- Sudden onset conditions (e.g. acquired spinal cord or brain injury)
- Intermittent and unpredictable conditions (e.g. epilepsy, ME)
- Progressive conditions (e.g. motor neurone disease, Parkinson's disease)
- Stable neurological conditions (e.g. cerebral palsy in adults)
How Can Neurological Disorders Cause Incontinence?
Urinary incontinence is the leakage of urine when you do not intend to urinate. It is a common condition, especially so in those with neurological conditions.
Neurological conditions affect the way that the body's nervous system, spinal cord, and nerves work. Damage to these can cause problems within your pelvic floor.
Nerves in the body control how the bladder stores and releases urine, and problems with these nerves can cause a variety of problems with the bladder, or the sphincters, or both, including:
- Bladder storage problems - Needing to urinate urgently and/or frequently or experiencing incontinence. You may experience urge incontinence that is caused by the bladder muscle contracting before the bladder is full (Overactive Bladder).
- Stress incontinence - Leaking urine when cough, sneeze, or strain in any way.
- Bladder emptying problems - Experiencing a delay between trying and starting to urinate, a slow or weak urinary stream, or feeling the need to strain.
Neurogenic bladder (neuropathic/atonic bladder) is a bladder dysfunction caused by neurologic damage. It occurs due to nerve signalling problems that can occur as a result of conditions such as multiple sclerosis, Parkinson's disease or stroke. This can cause the bladder to contract involuntarily and release urine, or even not contract at all, leading to urinary overflow.
Neurological disorders may be the cause of pelvic floor dysfunction if you experience:
- Constipation - Constipation is common in people who suffer from MS, Parkinson's disease and spinal injuries. These conditions often disallow the pelvic floor muscles to relax, making it hard to release stool. The conditions can also cause the colons to work at a slower pace, leading to fewer bowel movements.
- Urinary Incontinence - Neurological disorders can disrupt and prevent bladder control signals. As well as support from your pelvic floor muscles, bladder control relies on the signals from the nerve endings in your bladder that transmit to your brain. Neurological disorders can disrupt these signals and prevent them from reaching the brain, leading to involuntary urination and nocturnal enuresis (bedwetting).
Learn more about the causes of incontinence and how to diagnose the condition here.
How Can You Treat Pelvic Floor Disorders Caused by Neurological Disorders?
Incontinence - By working with your GP, you will be able to find an effective treatment to give you a lasting solution to incontinence. There are a range of conservative therapies used to tackle incontinence before surgery is considered. Click here to learn more.
Andrews, C.N., Storr, M. (2011) The Pathophysiology of Chronic Constipation [online]. Canadian Journal of Gastroenterology [viewed 16/10/2018]. 25(Suppl B); 16B-21B. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206564/
Bel Marra Health (2017) Atonic or Neurogenic Bladder: Signs, Symptoms, and Causes [online]. Bel Marra Health [viewed 16/10/2018]. Available from https://www.belmarrahealth.com/atonic-neurogenic-bladder-signs-symptoms-causes/
Neurological Alliance (2003) Neuro Numbers [online]. Neurological Alliance [viewed 16/10/2018]. Available from http://www.neural.org.uk/store/assets/files/20/original/NeuroNumbers.pdf
Neurological Alliance of Scotland (2018) Neurological Conditions Factsheet [online]. Neurological Alliance of Scotland [viewed 16/10/2018]. Available from http://www.scottishneurological.org.uk/content/res/Neurological_Conditions_Factsheet.pdf
NHS England (2018) Neurological Conditions [online]. NHS England [viewed 16/10/2018]. Available from https://www.england.nhs.uk/ourwork/clinical-policy/ltc/our-work-on-long-term-conditions/neurological/
NICE (2012) Urinary Incontinence in Neurological Disease: Assessment and Management [online]. NICE [viewed 17/10/2018]. Available from https://www.nice.org.uk/guidance/cg148/ifp/chapter/urinary-incontinence-related-to-a-neurological-condition
Shenot, P.J. (2018) Neurogenic Bladder [online]. MSD Manual [viewed 16/10/2018]. Available from https://www.msdmanuals.com/en-gb/professional/genitourinary-disorders/voiding-disorders/neurogenic-bladder
University of California San Francisco (2018) Neurological Disorders [online]. UCSF Health [viewed 16/10/2018]. Available from https://www.ucsfhealth.org/conditions/neurological_disorders/
Urology Care Foundation (2018) What is Neurogenic Bladder? [online]. Urology Health [viewed 16/10/2018]. Available from https://www.urologyhealth.org/urologic-conditions/neurogenic-bladder