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| What are the types of incontinence? |
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Stress Incontinence |
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If coughing, laughing, sneezing, or other movements that put
pressure on the bladder cause you to leak urine, you may have stress incontinence. Physical changes
resulting from pregnancy, childbirth, and menopause often cause stress incontinence. This type of
incontinence is common in women and, in many cases, can be treated.
Childbirth and other events can injure the scaffolding that helps support the bladder in women. Pelvic
floor muscles, the vagina, and ligaments support your bladder (see figure 2). If these structures
weaken, your bladder can move downward, pushing slightly out of the bottom of the pelvis toward the
vagina. This prevents muscles that ordinarily force the urethra shut from squeezing as tightly as they
should. As a result, urine can leak into the urethra during moments of physical stress. Stress
incontinence also occurs if the squeezing muscles weaken.
Stress incontinence can worsen during the week before your menstrual period. At that time, lowered
estrogen levels might lead to lower muscular pressure around the urethra, increasing chances of leakage.
The incidence of stress incontinence increases following menopause. |
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Urge Incontinence |
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If you lose urine for no apparent reason after suddenly feeling the need or urge
to urinate, you may have urge incontinence. A common cause of urge incontinence is inappropriate
bladder contractions. Abnormal nerve signals might be the cause of these bladder spasms.
Urge incontinence can mean that your bladder empties during sleep, after drinking a small amount
of water, or when you touch water or hear it running (as when washing dishes or hearing someone
else taking a shower). Certain fluids and medications such as diuretics or emotional states such
as anxiety can worsen this condition. Some medical conditions, such as hyperthyroidism and
uncontrolled diabetes, can also lead to or worsen urge incontinence.
Involuntary actions of bladder muscles can occur because of damage to the nerves of the bladder,
to the nervous system (spinal cord and brain), or to the muscles themselves. Multiple sclerosis,
Parkinson’s disease, Alzheimer’s disease, stroke, and injury—including injury
that occurs during surgery—all can harm bladder nerves or muscles. |
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Overactive Bladder |
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Overactive bladder occurs when abnormal nerves send signals
to the bladder at the wrong time, causing its muscles to squeeze without warning. Voiding up to seven
times a day is normal for many women, but women with overactive bladder may find that they must urinate
even more frequently
Specifically, the symptoms of overactive bladder include |
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urinary frequency—bothersome urination eight or more times a day or two or more times at night |
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urinary urgency—the sudden, strong need to urinate immediately |
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urge incontinence—leakage or gushing of urine that follows a sudden, strong urge |
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nocturia—awaking at night to urinate |
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Functional Incontinence |
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People with medical problems that interfere with thinking,
moving, or communicating may have trouble reaching a toilet. A person with Alzheimer’s disease,
for example, may not think well enough to plan a timely trip to a restroom. A person in a wheelchair may
have a hard time getting to a toilet in time. Functional incontinence is the result of these physical
and medical conditions. Conditions such as arthritis often develop with age and account for some of the
incontinence of elderly women in nursing homes |
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Overflow Incontinence |
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Overflow incontinence happens when the bladder doesn’t
empty properly, causing it to spill over. Your doctor can check for this problem. Weak bladder muscles
or a blocked urethra can cause this type of incontinence. Nerve damage from diabetes or other diseases
can lead to weak bladder muscles; tumors and urinary stones can block the urethra. Overflow incontinence
is rare in women. |
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Other Types of Incontinence |
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Stress and urge incontinence often occur together in women.
Combinations of incontinence—and this combination in particular—are sometimes referred to as
mixed incontinence. Most women don’t have pure stress or urge incontinence, and many studies show
that mixed incontinence is the most common type of urine loss in women.
Transient incontinence is a temporary version of incontinence. Medications, urinary tract infections,
mental impairment, and restricted mobility can all trigger transient incontinence. Severe constipation
can cause transient incontinence when the impacted stool pushes against the urinary tract and obstructs
outflow. A cold can trigger incontinence, which resolves once the coughing spells cease. |
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