Types of Urinary Incontinence
The bladder sits in the pelvis, supported by the pelvic floor muscles and surrounding ligaments, holding it in a naturally elevated position. The bladder constantly fills with urine, and can hold 1.5 - 2 cups before giving you the urge to urinate. The muscles around the bladder remain relaxed until you are able to reach a toilet, at which point they contract in coordination with the relaxation of your urethral sphincters (which are otherwise unconsciously contracted) to allow urine to flow out of your body in a steady stream.
Urinary incontinence (UI) can occur for a huge number of reasons, including; if your kidneys produce more urine than normal; your urethra is blocked; your bladder or urethra experience nerve damage; you are psychologically unable to urinate when you feel the urge; urine is constantly present in the urethra stimulating the urge to go; or you have inadvertently trained yourself to empty your bladder when it is not yet full.
A GP will diagnose the type of UI you are suffering from by its causes and when it occurs. This leads to a specific treatment plan being developed, which looks to resolve issues permanently by amending your lifestyle alongside any conservative therapy's and medical support.
Many men and women suffer from a degree of UI, and do not report their symptoms to their doctor. Studies report up to 55% of women suffer with urinary incontinence, with the true figure expected to be much higher. Whether for fear of embarrassment, or maybe it's seen as inevitable with age or childbirth. Even though UI is rarely life threatening, it can be much more than an inconvenience, severely effecting your quality of life, and the life of those around you.
There may be an easily resolvable cause of your UI, such as a urine infection, which can be treated quickly. As with most medical issues, the earlier you seek treatment, the quicker the resolution.
Types of Incontinence
Urinary incontinence (UI) can be diagnosed specifically, by the reason or event that leads to it occurring:
- Coital UI - Urinating during sex due to pressure on the bladder.
- Giggle UI (Laughter Leaks) - When you urinate as you giggle or laugh, as a result of relaxing your muscles.
- Stress UI - The most common form of UI. As a result of a physical movement such as heavy lifting, exercise, sneezing or coughing. Women are more likely to experience stress UI than men.
- Urge UI - Sudden and urgent desire to empty your bladder. Women are more likely to experience urge UI than men.
- Mixed UI - When you suffer from both stress and urge incontinence.
- Nocturia - Excessive night time urination; getting up more than twice a night to go to the bathroom.
- Overactive Bladder (OAB) - Sudden urge to urinate which may be difficult to stop in time to reach a bathroom. Women are more likely to experience an OAB than men.
- Overflow UI - Where you do not feel any urge to urinate and therefore your bladder overflows. Men are more likely to experience overflow UI than women.
- Double Incontinence - Due to both bladder and bowel incontinence having many of the same causes, you can also experience double incontinence (also known as combined incontinence), where urine, stool and gas all involuntarily leak.
Age UK. (2018). Incontinence. [online] Age UK, 2018. [viewed 18/04/18]. Available from: https://www.ageuk.org.uk/information-advice/health-wellbeing/conditions-illnesses/incontinence/
Botros, C. Dalalo, N. Eng, J. Iyer, S. Lozo, S. Botros, S. Tomezsko, J. Goldberg, R. Gafni-Kane, A. Sand, P. (2017). ICS 2017 Florence. Insensible urine loss, post-micturition dribbling, nocturnal enuresis, and coital incontinence: what does urinary incontinence mean today? [online] International Continence Society, 2017. [viewed 18/04/18]. Available from: https://www.ics.org/Abstracts/Publish/349/000702.pdf
Dwyer, N. T. (2006). Urology Board Review Manual. Stress Urinary Incontinence in Women. [online] 13(1), p 1-12. [viewed 18/04/18]. Available from: http://www.turner-white.com/pdf/brm_Urol_pre13_1.pdf
Hull, T. (2007). Clinics in Colon and Rectal Surgery. Fecal Incontinence. [online] 20(2), 118-124. [viewed 26/04/18]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780180/
Khandelwal, C. Kistler, C. (2013). American Family Physician. Diagnosis of Urinary Incontinence. [online] 87(8), p543-550. [viewed 23/04/18] Available from: https://www.aafp.org/afp/2013/0415/p543.html
Lozo, S. Botros, C. Iyer, S. Sand, P. K. (2017). NorthShore University HealthSystem/University of Chicago Medicine. Do patients know what we are talking about? [online] International Continence Society, 2017 [viewed 18/04/18]. Available from: https://www.ics.org/Abstracts/Publish/349/000324.pdf
Mota, R. L. (2017). International Brazilian Journal of Urology. Female urinary incontinence and sexuality. [online] 43(1), p20-28. [viewed 18/04/18]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5293379/
NHS. (2016). Urinary incontinence: Overview. [online] NHS Trust, 2016. [viewed 18/04/18]. Available from: https://www.nhs.uk/conditions/urinary-incontinence/
NICE, (2013). Urinary incontinence in women: management. National Institute for Health and Care Excellence, 2015. [viewed 18/04/18] Available from: https://www.nice.org.uk/guidance/cg171/resources/urinary-incontinence-in-women-management-pdf-35109747194821
NIH. (2013). Urinary Diversion. [online] National Institute of Diabetes and Digestive and Kidney Diseases, 2013. [viewed 18/04/18] Available from: https://www.niddk.nih.gov/health-information/urologic-diseases/urinary-diversion