Stress, urge, overflow and mixed incontinence

Urinary incontinence is going when you don’t want to go. It is a big deal because socially it’s just not acceptable and can lead to a lot of psychological stress. If you can’t remember the stages of voiding or the neural control, click here for a refresher.

Types of urinary incontinence

  • Stress: it is caused by an increase in intraabdominal pressure (laughing, coughing, sneezing) and a sphincter that can’t contract enough to prevent leakage
    • Most common type of incontinence in young women
  • Urge: uninhibited contractions of the detrusor muscle, common in older individuals
    • Common in older individuals
  • Mixed: most common type of incontinence, usually refers to a mix of urge and stress incontinence
    • Most common in general
  • Overflow: when the bladder is so full it cannot hold in the urine
    • Common when there’s an obstruction or spinal cord injury

A handy mnemonic to remember the general causes of incontinence is DRIP
Delirium (drugs, acute illness)
Retention (hypocontractility, outflow obstruction)
Inflammation/Infection/Impacted stool
Polyuria (drugs, high output)

Treatment

  • Lifestyle: scheduled voiding, regulating fluid intake, kegel exercises
  • Medications to treat underlying cause (especially anti-cholinergics to treat urge incontinence as the detrusor responds to cholinergic stimulation)
  • Surgery: Such as┬átension-free vaginal tape (sling) procedure (TVT) for treating stress urinary incontinence
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