Statistics and Facts
Urinary incontinence affects 200 million people worldwide.
- 1 in 4 women over the age of 18 experience episodes of leaking urine involuntarily.
- Urinary incontinence is twice as common in women as it is in men.
- Pregnancy and childbirth, menopause and aging are major reasons of the increased prevalence of incontinence in women as compared to men.
- Of the 25 million adult Americans suffering from some form of urinary incontinence, 75-80% of those are women.
- An estimated 60-70% of people affected by incontinence can be cured or better managed. (Continence Foundation of Australia).
What Are the Causes of Urinary Incontinence?
There are several different types of urinary incontinence:
Stress incontinence is the most common type. It occurs when the pressure in the bladder becomes too great for the bladder outlet to withstand. This is usually caused by weak pelvic floor muscles. Urine tends to leak most when you cough, laugh, sneeze or when you exercise (such as when you jump or run). In these situations there is a sudden extra pressure (stress) inside the tummy (abdomen) and on the bladder. Small amounts of urine often leak. Sometimes much larger volumes of urine are accidentally passed. Pelvic floor muscles are often weakened by childbirth. Stress incontinence is common in women who have had several children, in obese people and with increasing age. Stress incontinence can occur in men who have had some treatments for prostate cancer. This includes surgical removal of the prostate (prostatectomy), and radiotherapy.
Urge incontinence (unstable or overactive bladder) is the second most common cause. You have an urgent desire to pass urine. Sometimes urine leaks before you have time to get to the toilet. The bladder muscle contracts too early and the normal control is reduced. In most cases, the cause of urge incontinence is not known. This is called idiopathic urge incontinence. It seems that the bladder muscle gives wrong messages to the brain and the bladder may feel fuller than it actually is. Sometimes urge incontinence can occur because of problems with the nervous system (the brain, spinal cord and other nerves in the body). Illnesses or diseases affecting the nervous system are called neurological disorders. Some people with certain neurological disorders may experience urge incontinence. Examples are Parkinson’s disease, multiple sclerosis (MS), spinal cord injury and after a stroke.
Mixed incontinence. Some people have a combination of stress and urge incontinence.
Most cases of urinary incontinence are due to the above causes. Other causes are less common. They include:
Overflow incontinence. This occurs when there is an obstruction to the outflow of urine. The obstruction prevents the normal emptying of the bladder. A pool of urine constantly remains in the bladder that cannot empty properly. This is called chronic urinary retention. Consequently, pressure builds up behind the obstruction. The normal bladder emptying mechanism becomes faulty and urine may leak past the blockage from time to time. Treatment depends on the cause. An enlarged prostate gland in men is a common cause of overflow incontinence. It may be treated by surgical removal of the prostate (prostatectomy) or with medicines to shrink the prostate gland.
Bedwetting (nocturnal enuresis) occurs in many children but some adults are affected.
Functional incontinence is the name given to urinary incontinence where there is nothing obviously wrong with the nervous system controlling the bladder or the lower urinary tract (bladder/urethra) itself. An example would be incontinence because you were unable to reach the toilet, due to poor mobility.
Other types of incontinence exist. They include incontinence of urine when there is a birth defect (congenital abnormality) of the urinary tract, and problems that can occur after injury, accident or during operations
Who’s at Risk?
Risk factors for urinary incontinence
The risk factors most commonly linked with urinary incontinence include:
- pregnancy (both pre- and post-natal women)
- younger women who have had children
- menopause
- obesity
- urinary tract infections
- constipation
- specific types of surgery such as prostatectomy (removal of all or part of the prostate) and hysterectomy (removal of all or part of the uterus and/or ovaries)
- reduced mobility preventing you from getting to or using the toilet
- neurological and musculoskeletal conditions such as multiple sclerosis and arthritis
- health conditions such as diabetes, stroke, heart conditions, respiratory conditions, and prostate problems, and
- some medications.
Risk factors for faecal incontinence
A risk factor for faecal incontinence is urinary incontinence. Other risk factors are similar to those of urinary incontinence, but also include:
- chronic diarrhoea, and
- dementia.
- Although there are many risk factors for incontinence, only a few have undergone rigorous testing. If you fall into one of these risk categories and are worried about poor bladder or bowel control (or experience symptoms of incontinence) speak to your doctor or a continence health professional.
Important Health Alerts
Diabetes – If you are always feeling thirsty and having to urinate all the time, talk to your doctor. It’s important that you are checked to ensure that diabetes is not the problem.
Kidney health check – Apart from other important functions, your kidneys produce urine which is then drained into the bladder. Did you know that you can lose up to 90 percent of kidney function and not know it? Ask your doctor for a kidney health check which can include a urine test, blood test, blood pressure test, and healthy lifestyle assessment.
