Stress incontinence

Stress incontinence refers to leakage of urine on exertion or effort such as when coughing, laughing, exercising or sneezing. It may be caused by an ineffective closing off of the urethra (bladder tube) due to pelvic floor muscle weakness, traumatic childbirth injuries, low levels of oestrogen (resulting in thinning and weakening of the pelvic floor muscles) or pelvic nerve damage resulting from surgery eg: hysterectomy or radical prostatectomy.

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Urge incontinence:

Urge incontinence refers to a sudden, strong urge to pass urine. Urge incontinence occurs when the urgency is so great that leakage of urine occurs before the person can reach the toilet. Urge incontinence may be caused by poor bladder habits, hormonal changes, medicines such as diuretics, diseases affecting the nervous system (eg. Multiple Sclerosis), obstruction from an enlarged prostate, urinary tract infection, irritation from bladder stones, interstitial cystitis or other urological problems.

For many people putting the key in the front door or running water can exacerbate the problem.

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Mixed incontinence

Mixed incontinence is a mixture of stress and urge incontinence symptoms.

Reflex incontinence

Reflex incontinence occurs when the bladder empties due to reflex activity with no control of urination. This may occur with spinal cord lesions such as quadriplegia.

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Overflow incontinence

Retention with overflow incontinence occurs when the bladder is full and not able to empty properly, resulting in dribbling, poor stream, hesitancy, nocturia and post micturition dribble. It may be caused by obstruction from an enlarged prostate or narrowing (stricture) of the urethra or with faecal impaction when there is a full bowel pressing on bladder and stopping it from emptying properly.

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Atonic  bladder

An atonic bladder refers to an inability to empty the bladder effectively. It may be caused by spinal cord injury, diabetic neuropathy, or an overstretch injury of the bladder.

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Functional incontinence

Functional incontinence refers to passing urine in inappropriate places and incontinence due to an inability to get to the toilet. It may be caused by inability to recognise the toilet (due to cognitive impairment such as dementia), an inability to recognise when bladder or bowels need to be emptied, poor mobility skills  affecting the ability to get to an  appropriate toileting place or poor dexterity affecting the ability to remove clothing in order to toilet effectively.

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