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 tension-free vaginal tape (sling) procedure (TVT) for treating stress urinary incontinence