Incontinence: Definition, Types, Causes & Treatment

Instructor: Heather Zonts

Heather has taught in AD and BSN Nursing programs and has a master's degree in nursing.

This text lesson will discuss the definition of incontinence. We will also review the different types of incontinence including specific causes and treatments for each type.

What is Incontinence?

Incontinence occurs when someone loses control of bladder function. This loss of control occurs for many different reasons, and as you will see in the scenarios below, there are several different causes and treatments for incontinence.

Types, Causes, and Treatments of Incontinence

Bladder incontinence is when someone does not have control of urination (urination is also referred to as voiding) or loses control for a specific reason. It is not a normal process of aging and usually indicates a problem with the functioning of the urinary system. There are different types of bladder incontinence. Each will be discussed in the scenarios below.

First, we will discuss Sheila's case. Sheila is shopping at the store. All of a sudden, she needs to use the restroom to urinate. Unfortunately, the need to void overcomes her ability to hold in the urine. Consequently, she loses control of her urine and dribbles in her pants. She immediately remembers a commercial with the slogan, 'Got to go, Got to go, Got to go right now!' This type of bladder incontinence is urge incontinence.

Causes of this type of incontinence can include weak muscles in the perineum or weakened sphincter control. The sphincter is what closes off the urethra holding in the urine. Other causes include damage to the nervous system or injury to the bladder nerves. The nervous system is stimulated when the bladder fills. If this system is not functioning properly, urge incontinence may occur. Another cause of urge incontinence includes a urinary tract infection (UTI). UTIs can cause the bladder to spasm causing individuals to suffer from increased frequency as well as increased urgency to void. Again, in association with bladder stimulation, individuals suffering from diabetes have increased frequency of urination and may suffer from bladder spasms causing urge incontinence. Additionally, certain medications and foods that stimulate bladder contractions and filling can lead to an urgency to void.

Sheila goes to the doctor to find out what she can do to control this issue. The physician recommends she do exercises with the muscles in her perineum (contracting and relaxing) called Kegel exercises. He also prescribes her medication to decrease the contractions of the bladder to help with her urge incontinence. Another recommendation from the physician includes bladder training and/or timed voiding.

This picture shows the anatomy of the urinary system.
Urinary System

Now, we will shift to Jessica. Jessica is a school teacher and has been noticing that when she coughs, she tends to dribble urine in her pants. It also occurs when she laughs, coughs or sneezes. This type of bladder incontinence is called stress incontinence. It occurs more frequently in women because of weakened perineal muscles and sphincter control from the pressure of childbirth. It may also occur in men and may be associated with obesity and certain medications. Stress incontinence is associated with increased pressure on the bladder and sphincter, limiting the person's ability to hold their urine.

Jessica makes an appointment with her physician to see what she can do to prevent this from occurring. Her physician recommends she do Kegel exercises to strengthen the perineum.

Another type of incontinence that includes both Sheila's and Jessica's symptoms is called mixed incontinence. When an individual suffers from mixed incontinence, they have the urgency combined with voiding caused by increased pressures in the abdomen.

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