Causes and types of urinary incontinence for women

Causes and types of urinary incontinence for women

After treating male urinary incontinence, it is time to talk about female urinary incontinence. As a reminder, urinary incontinence is manifested by uncontrollable and involuntary loss of urine, which occurs during the day or at night. Urinary incontinence in women is far from inevitable.

 

1 - THE MAIN CAUSES OF FEMALE URINARY INCONTINENCE

 

  • Weakening of the pelvic floor muscles (which may be due to pregnancy, childbirth, relaxation of the muscles...)

 

  • The "bladder descent" that occurs when the tissues between the bladder and vagina weaken to the point of no longer supporting the weight of the bladder

 

  • A chronic health problem that affects the control of bladder muscles through the nerves

 

  • Taking certain medications (antidepressants, nasal decongestants, muscle relaxants)

 

  • Constipation with fecal impaction (compressed and hardened seals)

 

2 - FOCUS ON STRESS URINARY INCONTINENCE

 

In women, this type of incontinence manifests itself as an involuntary leakage of urine that occurs during certain harmless efforts of daily life (sneezing, running, gym...) and can cause urination without feeling the need to urinate. Stress urinary incontinence mainly affects women and is related to a dysfunction of the urethra canal (especially when it is closed).

 

Sphincterial insufficiency

 

The sphincter of the bladder neck is responsible for opening and closing the bladder neck during urination. It is comparable to a "tap" that can be opened and closed. However, in cases of sphincter insufficiency, it no longer plays its role properly: when the abdomen exerts pressure on the bladder, the sphincter is not able to provide sufficient contraction to stop the flow of urine.

 

This dysfunction leads to a loss of urine during an effort, even if it is very slight. Indeed, abdominal pressure is applied to the perineum, whose muscles no longer provide control. During exercise, the sphincter and perineum do not resist pressure, causing bladder weakness.

 

Loss of anatomical support

 

The anatomical support consists of the anterior vaginal wall, perineal muscles, bladder neck and the initial portion of the urethra. Its role is to provide support for the base of the urethra and bladder during exercise. When the anatomical support no longer plays its supporting role, we speak of a fall of the bladder neck which is responsible for stress urinary incontinence.

 

3 - FOCUS ON URINARY INCONTINENCE BY IMPERIOSITIS

 

Urge incontinence is characterized by uncontrolled bladder weakness. The second name for imperiosity incontinence is "overactive bladder". The main syptoma is the immediate need to urinate. In this case, urinary leakage is accompanied by an urgent need to urinate.

 

The mechanism of this type of incontinence

 

As explained above, the bladder is closed by the urethral sphincter which prevents bladder weakness. In case of urge incontinence, the sphincter is subjected to too much pressure: the bladder contracts abnormally during filling and therefore exerts a high pressure. The urine can then exit through the urethra without being conscious.

 

This abnormal contraction results from a reaction of the parasympathetic nerve, responsible for the body's automatic mechanisms (breathing, heartbeat, etc.). The parasympathetic nerve normally consciously sends acetylcholine molecules. These molecules then cause a completely desired contraction of the bladder.

 

However, in a person suffering from incontinence, control of the release of acetylcholine (a neurotransmitter that plays an important role in both the central nervous system and the autonomic nervous system) does not exist. The person with the disease is unaware of the contraction of his bladder and urination takes place without him having had time to understand.

 

The consequences

 

Women with this type of incontinence are under daily stress: bladder control is no longer possible. Women who suffer from urge incontinence are subjected to frequent, impromptu urination at any time of the day. This can happen at any time: whether the bladder is full or not. It is then necessary to adapt the protections to avoid any incident.

 

Sources

Health Passport