What's urinary incontinence?

Urinary incontinence (UI) is any involuntary leakage of urine. It can be a common and distressing problem, which may have a deep impact on quality of life. Urinary incontinence almost always results from an underlying treatable medical condition but it is under-reported to medical practitioners.

Continence and micturition involve a balance between urethral closure and bladder (detrusor muscle) activity. Urethral pressure normally exceeds bladder pressure, resulting in urine remaining in the bladder. The proximal urethra and bladder are both within the pelvis. Intra-abdominal pressure increase (from coughing and sneezing) is transmited to both urethra and bladder equally, leaving the pressure differential unchanged resulting in continence. Normal voiding is the result of bladder (detrusor muscle) contraction, up to a point that overcomes the urethral retention pressure, allowing the urine flow and normal micturition.

Incontinence will happen when there is an increase of the intra-abdominal pressure and pelvic floor muscles do not properly support the urethra.

Total incontinence may happen if the urethra is permanently opened, allowing the urine free leakage from the bladder. Patients will leak even at rest, with no stress at all.

Female Incontinence Prevalence

Urinary Incontinence approximately affects 200 million people worldwide, according to the National Association for Continence (NAFC). It is estimated that between 75-80% are women.

Prevalence of incontinence in general population of females reported in 13 different studies.

Young adult, 20% to 30%; Middle age, 30% to 40%; Elderly, 30% to 50%.

Male Incontinence Prevalence

Men can limit the risks of developing urinary incontinence by reducing the consumption of caffeine and alcohol, by keeping their weight down, by not smoking, by avoiding constipation and doing Kegel exercises to improve the muscles activity at the bladder’s level.

Stress incontinence in men is rare unless the patient has undergone some type of prostate surgery or has suffered neurological injury or trauma. Incontinence in men increases with age and appears to rise more steadily than it does in women.