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Incontinence

Definition of Incontinence

The urinary system plays an essential role in eliminating waste from the blood and converting it into urine by the kidneys. Urine is stored in the bladder, undergoing filling and emptying phases throughout the day.

According to the WHO, urinary incontinence is defined as involuntary urine leakage that socially and professionally affects those who suffer from it. It is a common symptom affecting more than 3 million people in France.

Urinary incontinence is not a disease in itself but a symptom related to various medical conditions, such as urological, gynecological, or neurological problems.

There are 5 types of urinary/fecal incontinence:

  • Stress Incontinence: Leakage associated with physical exertion, with incomplete emptying during leakage.
  • Urge Incontinence: Leaks not related to exertion, preceded by an urgent need to urinate, often caused by bladder hyperactivity or neurological causes.
  • Mixed Incontinence: Combination of urge urinary incontinence and stress incontinence in the same patient.
  • Overflow Incontinence: This variant of incontinence, known as urge incontinence or urgenturia, manifests as leaks during urgent needs to urinate. These incidents may occur as small urine leaks (a few drops) or, in some cases, more significant leaks or even complete involuntary urination (the bladder empties suddenly due to the urgency felt).
  • Functional Incontinence: Urine leakage due to chronic bladder retention, usually treated by urinary catheterization.

Micturition, or bladder emptying, is a voluntary and active process controlled by nerve impulses from the brain, governing the contraction of the bladder muscle (Detrusor) and the relaxation of the closing muscles (bladder sphincters) of the urethra.

The frequency of emptying depends on the amount of fluid consumed daily and the individual bladder capacity, which varies from person to person.

Causes of Urinary Incontinence

The causes of urinary incontinence are diverse, and the most common is muscle and ligament trauma that occurs during childbirth. Indeed, even if childbirth was not particularly traumatic or complicated, it causes tissue stretching, which often leads to urinary incontinence. However, many cases of urinary incontinence occurring during pregnancy or after childbirth disappear shortly afterward. Nevertheless, urinary incontinence can occur shortly after childbirth, but also later on, sometimes even years later.

Other causes of stress incontinence include:

Aging of tissues, especially after menopause;
Intense physical exertion, especially those that cause a significant and/or sudden increase in pressure in the abdomen. This phenomenon occurs particularly during the practice of certain sports (tennis, jumping, carrying heavy loads), but also in cases of constipation.
In some cases, no cause is really found. This is the case with some young women who have not had children and who may still experience stress urinary incontinence.

Consultation with your general practitioner is imperative at the first signs.