Restore Your Freedom

Disorders of the pelvic floor are common with sufferers experiencing a loss of freedom and control

Types and symptoms of bladder incontinence

Bladder incontinence is when there is some degree of urine leakage. This can be due to muscular or nerve damage, infection or disease. But bladder control problems aren't just about leakage.

Overactive Bladder (OAB) can make you feel the need to go to the toilet frequently, both during the day and at night.

Types of bladder control problems

Stress incontinence is the most common form of leakage. It usually affects women after childbirth or menopause, although men can get it too. It's characterised by a little bit of leaking when sneezing, laughing, coughing or during exercise or sex.

Anything that makes you strain against your abdomen can cause pressure against the pelvic floor muscles which need to be tense to ensure the plumbing is kept closed. If these muscles are weak, they can't maintain that tension. When that tension is lifted, the urethra opens and just a little urine can leak out.

Overactive bladder (OAB) or urgency urinary incontinence (or urge incontinence) can happen for several reasons and to a range of people. It's an involuntary contraction (tightening) of the bladder which causes partial or complete emptying. The bladder doesn't have to be full for this to happen.

People may feel the need to go to the toilet frequently, both during the day and at night, but only pass a trickle of urine.
People with OAB can be wet, which means they need to go frequently and they have some leakage; or dry, which means they don't have any leakage, just a need to go to the toilet a lot.

Mixed incontinence is when someone has symptoms of more than one type of incontinence, usually the stress and urge types. Often, though, one set of symptoms can be more bothersome than another. It's important to tell your healthcare professional about all your symptoms to ensure you receive the most appropriate treatment.

Overflow incontinence is when the bladder fills beyond its capacity. Typically, people have constant or frequent dribbling of urine and are never quite satisfied that their bladder has fully emptied. Sometimes it has similar symptoms to stress and urge incontinence. It can happen because the communication systems (the nerves) between the brain the bladder are damaged. Or it can happen because of a blockage (such as in the urethra), which causes an overfilling which in turn causes overflow and leakage.

Functional incontinence is when someone isn't holding in their urine because of a reason that has nothing to do with bladder function. For instance, people can't get to a toilet because of chronic illness or mobility issues. Sometimes people with functional incontinence also have other bladder control problems that need to be treated.

Reflex incontinence is when someone loses control over the mechanisms of bladder function. This can be caused by injury, such as a spinal injury, or as a consequence of surgery. It can also happen without any obvious cause. It's characterised by a constant dribble or a total loss of urine without the person knowing (and is sometimes called unconscious incontinence).

Dual incontinence is when someone has both bowel and urinary incontinence.

Cystitis and urinary tract infections

Both men and women can get urinary tract infections or cystitis, which is caused by a bacterial infection. Symptoms of cystitis are a frequent need to go the toilet, pain, a burning sensation and a strong smell. It's treated with antibiotics and usually clears up within a few weeks, although it can go on for longer because of resistant bacteria.

Interstitial cystitis is sometimes referred to as non-bacterial cystitis or painful bladder syndrome. It is chronic (continuing for years) and no one knows what causes it. Urine tests don't show bacterial infection. Doctors also refer to it as idiopathic (no known cause).

Interstitial cystitis causes the bladder wall to become irritated and inflamed. There's a frequent need to urinate. It can be extremely painful around the bladder and abdomen, pelvic area and the perineum (between the anus and vagina). Men may have pain in the penis and scrotum. The bladder's inflammation can cause scarring, decreased bladder capacity and some bleeding.

Retention

Urinary retention can be acute (sudden) or chronic (ongoing or recurring). It means, as the name implies, that urine is retained in the bladder. Acute retention is characterised by extreme difficulty passing urine.The build up of urine in the bladder causes great pain.

In chronic retention, which is usually painless, a little urine can be passed but the bladder doesn't empty completely.

Urinary retention can happen because of a blockage (such as a stone in the bladder), nerve damage, or, in men, enlargement of the prostate gland.

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