Incontinence, urinary

Involuntary passing of urine, often due to injury or disease of the urinary tract. There are several types. Stress incontinence refers to the involuntary escape of urine when a person coughs, picks up a heavy package, or moves excessively. It is common in women, particularly after childbirth, when the urethral sphincter muscles are stretched. In urge incontinence, also known as irritable bladder, an urgent desire to pass urine is accompanied by inability to control the bladder as it contracts. Once urination starts, it cannot be stopped. Total incontinence is a complete lack of bladder control due to an absence of sphincter activity, which may be associated with spinal cord damage. Overflow incontinence occurs in longterm urinary retention, often because of an obstruction such as an enlarged prostate gland. The bladder is always full, leading to constant dribbling of urine. Incontinence may also be due to urinary tract disorders (including infections, bladder stones, or tumours) or prolapse of the uterus or vagina. Incontinence due to lack of control by the brain commonly occurs in the young (see enuresis) or elderly and those with learning difficulties. If weak pelvic muscles are causing stress incontinence, pelvic floor exercises may help. Sometimes, surgery may be needed to tighten the pelvic muscles or correct a prolapse. Anticholinergic drugs may be used to relax the bladder muscle if irritable bladder is the cause. If normal bladder function cannot be restored, incontinence pants can be worn; men can wear a penile sheath leading into a tube connected to a urine bag. Some people can avoid incontinence by self-catheterization (see catheterization, urinary). Permanent catheterization is necessary in some cases.