Bladder weakness, urine incontinence

Urine incontinence (lat.: Incontinentia urinae) is the loss or the failure to learn to keep urine safely and discharge it at an intended place to a self-willed time.

Forms of urine incontinence

Urge incontinence

The not-controllable urinary urgency causes urine loss before reaching the toilet. This can have several causes:

Sensory urge incontinence: Here the perception of the bladder filling is disturbed in the sense of a premature feeling of filling, for example due to an inflammation, bladder stones or occlusion of the discharging urinary passages.

Motor urge incontinence: Here the nerve impulses leading towards the outside of the muscles of the bladder wall (the urinary bladder muscles responsible for relief) are disinhibited, which leads to a premature, sometimes convulsive detrusor-contraction.

The urge incontinence may be the result of inflammation of the lower urinary tracts (urinary bladder, urethra), of obstructive (closing) modifications like for example urethra stricture, benign respectively malign prostate enlargements or also of neurological disorders like e.g. dementia

Giggle-Incontinence (Enuresis risoria): Giggle-Incontinence is a special form of urge incontinence. Involuntary urine loss occurs upon heavy laughter, which is however difficult to determine clinically. This relatively rare form of urge incontinence is mainly perceived with younger girls, this form of incontinence has until now basically never been perceived with boys or even adults. The cause is a deficit of the central nervous block to the miction reflex.

Stress incontinence = strain incontinence

In case of a stress incontinence the increased inner stomach pressure due to strain, pressure for different reasons (lifting, carrying, stairs, laughing, coughing, sneezing) triggers the loss of urine at a lower or higher level. Triggers can be e.g. coughing, sneezing, and abrupt body movements; in major cases even also effortless movements. With women, stress incontinence is frequently caused by childbirth, which leads to hyperextension and slackening of the retainers and the pelvic floor.

Further known forms are Mixed incontinence (meaning urge and stress incontinence combined), Overflow incontinence (constantly overfull urine bladder due to discharge disorders) and Reflex incontinence due to central nervous disorders (e.g. after paraplegia or Multiple Sclerosis).

Source: Wikipedia 2007

For the prevention of incontinence and already in case of existing bladder weakness sufficient liquid intake and regular pelvic floor training is recommended in any case. Numerous self help groups offer extensive information see also Web links.