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| Giving Care : Facts |
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| Prevalence |
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Bladder weakness or urinary incontinence is very common. It has been estimated that about 2 million people in Canada are likely to suffer regularly from the condition and for nearly 500,000 of these, it is a daily occurrence. Faecal incontinence is the least common type of incontinence.
Many people with a weak bladder may never seek help or advice. This is often due to embarrassment about discussing an intimate subject, a lack of understanding or fear of knowing about the cause or the treatment required.
For those that do seek help or advice the condition can in most cases be cured or at least considerably improved. Our advice is therefore to encourage anybody with bladder problems to discuss their situation with their doctor. |
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| What causes it? |
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Weakened pelvic floor muscles
The bladder and outlet passage are supported and held in place by a hammock of muscles called pelvic floor muscles that keep your bladder closed. If these muscles lose their strength and flexibility even everyday activities such as coughing may cause leaking.
Pelvic floor muscles can become stretched and weakened during childbirth. Being overweight can also put an added strain on them.
Menopause
All body muscles become weakened over time and after menopause the reduction in the quantity of estrogen also affects the abdominal muscles. As a result, the bladder shifts its position and the muscles around the urinary tract become less effective.
Prostate
The most commonly experienced type of bladder weakness by men is a continuous dripping. This is often caused by a swollen prostate impeding the passage of the urine when urinating. As a result, the bladder is not completely emptied.
Men's bladders can become temporarily weakened after a prostate operation although generally speaking things get back to normal after about a year.
Other causes
Obesity can also lead to urine loss as it places undue strain on the abdominal and pelvic muscles.
Smoker's cough can also be an indirect cause of leaking as the coughing is frequent and often more violent. The greater risk of contracting the circulatory diseases that smoking causes and the subsequent prescription of diuretic medicines will also increase the risk of leaking.
Nerve damage, some medications, constipation or even an infection can also lead to bladder weakness.
Types of incontinence
As some of the following classifications show, bladder problems can be experienced in many different ways depending on its physical cause. Nevertheless, bladder problems should always be regarded as a symptom of a disease or disability and not as a disease in itself.
Stress
Unexpected leaking when you laugh, cough, sneeze or do some kinds of physical training. Most often weakened pelvic floor muscles or menopause are the causes.
Urge
You experience a strong and sudden urge to pass urine. The bladder tries to empty despite your efforts to restrain leaking. There is a lack of co-ordination between impulses the brain gives to the bladder and what your bladder does.
Overflow and drip
When your bladder does not empty completely urine builds up and in the end may begin to dribble out.
Mixed symptoms
It is fairly common to have more than one type of symptom. Although more seldom, faecal incontinence often combined with urine incontinence does occur.
Definitions
'Urinary incontinence is the involuntary loss of urine which is objectively demonstrable and a social or hygienic problem.' (Anderson, J.; Abrams, P.; Blaivis, J.G.; Stanton, S.L.: 'The standardisation of terminology of lower urinary tract function'. In: Scandinavian Journal of Urology and Nephrology, Supplement, 1988; 114:5-19).
'An acontractile bladder is defined as one that cannot be shown to contract during urodynamic studies.' (Abrams, P.; Blaivis, J.G.; Anderson, J.T.: ' The standardisation of terminology of the lower urinary tract function'. In: Scandinavian Journal of Urology and Nephrology, Supplement, 1988; 114:5-19).
'Stress incontinence occurs when bladder pressure exceeds maximum urethral pressure in the absence of detrusor muscle activity.' (O'Dowd, T.: 'Management of urinary incontinence in women'. In: British Journal of General Practice, 1993; 43: 426-429).
'Overactive bladder (detrusor instability) is when the bladder objectively contracts, spontaneously or on provocation during the filling phase while the patient is attempting to inhibit micturition.' (International Incontinence Society: 'The standardisation of terminology of the lower urinary tract function'. In: British Journal of Obstretics and Gynaecology, Supplement, 1990; 1-16).
'Constipation can be defined as a decrease in the frequency of defaecation differentiated by hard formed stools which are difficult to pass.' (Mcmillan S., Williams, F.: 'Validity and reliability of the Constipation Assessment Scale'. In: Cancer Nursing, 1989; 12,3, 182-183).
'Faecal incontinence is the involuntary or inappropriate passage of faeces.' (Royal College of Physicians: 'Incontinence: Causes, Management and Provision of Services'. 1995). |
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