Hey! Am I leaking?! (Or, the birds & the bees of incontinence terminology.)Nov 01 '01 (Updated Dec 20 '01) Write an essay on this topic.
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The Bottom Line This glossary explores common types of incontinence, and will hopefully increase awareness and understanding towards a problem that plagues so many.
This is Part 2 in a series of glossaries I'm writing about incontinence. As I am not a "certified expert" in this field, but rather someone who suffers from these problems, I assembled this glossary by researching and gathering information from other resources on and off the internet. If you have any additional information that should be added, or notice corrections that should be made, please email me the details and I'll make the necessary adjustments as soon as possible. Please use this glossary as a reference guide only. This information is not intended as a diagnostic tool and should not be used for diagnosis. If you are experiencing incontinence problems, you should speak with your doctor immediately! What exactly is incontinence? Simply stated, incontinence is defined as the failure or the inability to control the evacuation of the bladder and/or bowel. Incontinence has also been defined as an involuntary loss of urine and/or stools at an inappropriate time or in an inappropriate place. The amount can vary from very slight to copious, can be continuous or periodic, and can occur in everyone from children to the elderly. It's important to note that incontinence itself is not considered a disease, but rather a symptom of an underlying problem. A broad range of conditions and disorders can cause incontinence in men and women, including birth defects, pelvic surgery, injuries to the pelvic region or to the spinal cord, nerve damage, neurological diseases, infection, and degenerative changes associated with aging. Both bladder and bowel incontinence can also occur as a result of pregnancy or childbirth. BLADDER (URINARY) INCONTINENCE: Normally, the bladder stores urine until it is convenient to urinate, but when any part of the urinary system is disrupted, incontinence can result. Urinary incontinence can be experienced in different ways depending on its physical cause. Common types of urinary incontinence include: Dribble Incontinence - Dribble incontinence only affects men and involves the appearance of additional urine shortly after going to the bathroom. Essentially, small amounts of urine are left in the horizontal part of the urethra when the surrounding muscles are unable to 'squeeze' out all of the liquid. This remaining urine then leaks out after sufficient movement, such as walking. Dribble incontinence is a common problem among men of all ages. Enuresis - Enuresis is the term most widely used to describe bedwetting in children who are old enough to be "potty trained", and adults who experience loss of bladder control at night. Nocturnal (night-time) enuresis usually affects otherwise healthy children and can last long into their teens, and in rare cases for the rest of their lives. Enuresis can result from several conditions, including physical abnormalities in the urinary system to nervous system disorders. Overflow Incontinence - Overflow incontinence refers to the frequent and involuntary leakage of urine due to excessive urine in the bladder. Overflow incontinence is primarily caused by an obstructed outflow and/or dysfunctional bladder muscles. In the case of an obstructed outflow, the bladder muscles have to work against an increased pressure in order to empty the bladder, usually preventing urination. After a while, however, the bladder becomes so full that the excess urine is pressed out despite the resistance (but still leaving the bladder mostly full). Some causes of an obstructed outflow include an enlarged prostate gland, stones, or a tumor. Other causes of overflow incontinence can be prostate problems, diabetes, spinal cord damages, or damages in the central nervous system. Frequent visits to the bathroom with only small amounts of urine released are usually symptoms of overflow incontinence. Reflex Incontinence - Reflex incontinence involves the involuntary loss of urine by an individual who is unaware of the need to urinate. There is no voluntary control emptying the bladder, and it is common not to feel any urinary urge or stress. Reflex incontinence may result from damage affecting the spinal cord or the central nervous system, where the result prevents nerve impulses from getting through to the bladder and sphincter muscle. In some cases, the affected person will be alerted to an incontinent episode only by the sensation of wetness. Stress Incontinence - Stress incontinence refers to the leakage of urine when coughing, sneezing, laughing, lifting, jogging, or anything else that causes the abdominal pressure to be stronger than the bladder’s closure mechanism. Stress incontinence is the most common form of urine leakage among women, but can also occur in men. With this type of incontinence leakage only occurs in small quantities, although it does occur with no advance sensation of needing to empty the bladder. A common cause of stress incontinence in women is weak or damaged pelvic muscles (which can be caused by childbirth, menopause, or ageing). In men, it can occur after an operation on the prostate gland. Stress incontinence can often be treated with simple exercises. Urge Incontinence - With urge incontinence, the sufferer suddenly feels that his or her bladder must be emptied only moments before the bladder is entirely voided. Since the bladder is emptied completely, the leakage is often very substantial. Urge incontinence occurs when nerve passages within central nervous system are damaged, causing a sudden bladder contraction that cannot be consciously inhibited. The result is that the sufferer has no conscious control over when urination takes place. In men, urge incontinence is often a consequence of the prostate becoming enlarged, which presses around the urethra and creates the need to urinate. Others causes can include the presence of a stone or tumor, which irritates the bladder and prevents the urine from running as it should. Breaks in the nerve paths can be caused by ageing, or damage from neck, head and spinal injuries. In some cases of urge incontinence, there is no physical explanation; everything is working as it should, but the urge is still experienced. BOWEL (FECAL) INCONTINENCE: Fecal continence depends on functioning muscles and nerves in and around the rectum and anal canal, and incontinence can occur when something is wrong with any of these mechanisms. Ultimately the result of fecal incontinence is the involuntary loss of stools. A few of the possible causes include impairment or damage to muscles or nerves, inflammatory bowel disease, constipation or impactment, prolapse, stroke, or an abnormal pelvic floor. As can be expected, different causes of bowel incontinence will result in different symptoms. Unfortunately, these symptoms have not been broken into standard categories as with bladder incontinence. Nevertheless, similarities do exist between the nature of symptoms for bladder and bowel incontinence, so I have created and named categories based on these similarities. Please remember that these are not official medical categories for bowel incontinence: Overflow Incontinence - With these symptoms, the sufferer usually only experiences small amounts of leakage, but the leakage can vary from periodic to continuous. In cases where leakage occurs continuously, it can be difficult to manage due to its unremitting nature. One possible cause of this problem is weak or damaged sphincter muscles which can no longer hold feces within the rectum as more waste is produced. Reflex Incontinence - In this case, the bowel periodically voids even though the sufferer is unaware of the need for a bowel movement. Essentially the sufferer has no voluntary control over emptying the bowel and is unable to tell when it will. Usually the bowel is emptied completely, so the resulting leakage can be substantial. A possible cause of this symptom is nerve damage, resulting in the loss of sensation and control over muscles involved in the evacuation of feces. Urge Incontinence - With these symptoms, the sufferer suddenly feels that the bowel must be emptied only moments before the bowel is entirely voided. A common cause of this problem is severe diarrhea (possibly from irritable bowel syndrome or inflammatory bowel disease), which simply can not be held back due to its consistency. Since the bowel is emptied completely, the leakage is often very substantial.  |
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