Urinary Incontinence

Causes and Risk Factors

• Stress incontinence is caused by a weakening or defect in one’s pelvic floor or sphincter muscles. These muscles control the body’s ability to retain urine in the bladder during filling. Activities such as coughing, sneezing, and lifting cause an increase in intra-abdominal pressure, thereby placing pressure on the bladder.¹¹ Normally, the pelvic and sphincter muscles are strong enough to contain the contents of the bladder during exertion. However, those with SUI experience brief leaks while exerting themselves, yet regain control once at rest. SUI occurrences typically do not result in complete voiding.¹²

  • Risk factors for SUI include pregnancy, childbirth trauma, obesity, menopause and pelvic floor surgery.¹³¹⁴

• Urge incontinence is caused by the abnormal contraction of the detrusor muscle, which is responsible for the expulsion of urine through the urethral sphincters.¹⁵ This type of UI is also known as overactive bladder syndrome, and is associated with a frequent sensation and need to urinate; at night the individual may wake up frequently to use the restroom (nocturia) and may experience periodic incontinent episodes.¹⁶

  • Risk factors for UUI include those with neurological abnormalities and a lower bladder volume tolerance. However, patients suffering from UUI may not have a direct physiological cause for their condition.¹⁷

• Overflow incontinence is caused by the inability to completely void the bladder (urinary retention), leading to its overdistention and subsequent leaking due to immense pressure buildup.¹⁸ The individual may sense an increased urge to and inability to urinate, with frequent “dribbling” voids and nocturia.¹⁹

  • More common in older men, risk factors include having an enlarged prostate, pelvic surgery, constipation, and urethral stricture caused by trauma, inflammation or infection.²⁰²¹

1. ^{1,3,4,10,11,13,15,28,29,40}Leaver, R. (2017). Assessing patients with urinary incontinence: the basics. Journal Of Community Nursing, 31(1), 40-46.
2. ^{2,5,12,16,19,23,26,31,32,33,42,43}Bardsley, A. (2016). An overview of urinary incontinence. British Journal Of Nursing, 25(18), S14-S21.
3. ^{6,14,17,18,20,30,35,37,38,39,44}Testa, A. (2015). Understanding Urinary Incontinence in Adults. Urologic Nursing, 35(2), 82-86. doi:10.7257/1053-816X.2015.35.2.82
4. ^{7,21,24,25,27,34,41,45}Barrie, M. (2015). Identifying urinary incontinence in community patients. Journal Of Community Nursing, 29(6), 45-52.
5. ^8,9Gorina, Y., Schappert, S., Bercovitz, A., Elgaddal, N., & Kramarow, E. (2014). Prevalence of incontinence among older americans. Vital & Health Statistics. Series 3, Analytical And Epidemiological Studies, (36), 1-33
6. ²²Beeckman, D., Van Damme, N., Van den Bussche, K., & De Meyer, D. (2015). Incontinence-associated dermatitis (IAD): an update. Dermatological Nursing, 14(4), 32-36.
7. ³⁶Nazarko, L. (2015). Person-centred care of women with urinary incontinence. Nurse Prescribing, 13(6), 288-293.