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Causes of Urinary Incontinence

The causes of UI

What causes incontinence?

A: Urinary incontinence can be caused by a variety of different factors and life events. These can vary greatly. One can begin to develop incontinence due to natural factors; for example aging or as a side effect of illnesses (like in the case of conditions like MS). On the other hand one can also develop UI from behavioral choices; for example drinking significant amounts of alcohol, caffeine or carbonated drinks. The cause of one’s incontinence will also differ depending on what type of urinary incontinence one happens to be experiencing. This means that different triggers will cause different types of incontinence and vice versa. The cause and type of incontinence one experiences will also affect the treatment that is recommended or most effective for each person.

Q: What causes urinary incontinence?

A: Temporary urinary incontinence can be caused by certain foods and drinks (alcohol, caffeine, carbonated drinks, spicy foods, acidic foods, sweeteners). Other factors that can lead to temporary urinary incontinence include UTIs and constipation.

Persistent urinary incontinence can also be caused by the following for both sexes.

- Aging: Over time the bladder and urethral sphincter muscles may naturally weaken, thus leading to the inability to properly control urination.

- Obstruction: Tumors or urinary stones can block the normal voiding of the bladder and thus lead to overflow incontinence. 

- Neurological disorders: Disorders like multiple sclerosis can cause problems with the nervous system - this includes the nerves that control bladder function and control - thus, often, causing incontinence.

- Obesity: Added weight can put added pressure on the bladder leading to incontinence. 

- Smoking: Tobacco is a bladder irritant and can contribute to  incontinence.


    Q: What causes incontinence in women?

    A: Women are significantly more likely to develop incontinence. In fact, they are more than twice as likely to be experiencing UI when compared to men. In numbers, 1-in-3 women over the age of 18 experiences some form of incontinence in the US.  

    When looking at what causes incontinence in women we are often looking at things that, for many, are a natural part of the biologically female experience. Women's pelvic floors are more vulnerable as a result of a couple factors that increase the likelihood of developing UI:

    - Pregnancy: Both changes in hormones and the added weight of a growing child can put pressure on the pelvic floor leading to UI.

    - Childbirth: Natural birth can weaken the pelvic floor muscles and even damage the pelvic nerves. Childbirth also can lead to pelvic organ prolapse which commonly co-occurs with incontinence.

    - Menopause: After menopause women’s estrogen production will decrease. This hormone is associated with healthy tissue in the bladder lining and urethra and declining levels can contribute to incontinence.

    - Hysterectomy: This surgery which involves the removal of the uterus can affect pelvic nerves involved with bladder control.  It is rare that hysterectomy alone is the main cause of urinary incontinence.

      Q: What causes stress incontinence?

      A: Stress incontinence is caused by the weakening of the muscles and connective tissues that support the urethra. Stress incontinence occurs when engaging in physical activity that increases the pressure in the belly, this can even be low impact actions like sneezing or coughing. Most commonly stress incontinence is caused by muscles that are weakened in childbirth or prostate surgery leading to the inability to hold in urine when physical bodily stress is put on the bladder. However, obesity, aging, chronic coughing, smoking, and high impact activities can also lead to the weakening of these same muscles, and thus lead to stress incontinence.

      Q: What causes urge incontinence? What causes urinary urgency incontinence?

      A: Urge incontinence is when one has a sudden urge to urinate that cannot be delayed. Urge incontinence occurs when the bladder muscles contract at the wrong time, causing the bladder to begin to squeeze in preparation for urination even if the bladder is not full. This can either lead to leakage or the feeling of needing to urinate more frequently than normal. In most cases there is no specific cause of urge incontinence. However, the following conditions can result in urge incontinence:

      - Bladder inflammation

      - Bladder infection: The most common of which is a urinary tract infection (UTI)

      - Neurologic diseases such as MS or stroke

      - Nerve injury or neuropathy due to diabetes and other medical conditions

      - Bladder Cancer

        Q: What age does incontinence start?

        A: Incontinence can start at any age, but the majority of women who experience UI are between the ages of 30 and 80 years old. Midlife and later life experiences tend to trigger incontinence in women specifically. These experiences include pregnancy, childbirth, and menopause. More than 4-in-10 women 65 and older have urinary incontinence. The age that one experiences menopause or has one's first child can also influence whether the onset of age-related incontinence is earlier or later in life. It is also the case that the pelvic floor gradually weakens over the course of one's life - which can lead to incontinence, thus rates of incontinence increase with age.

        Q: Does constipation cause urinary incontinence?

        A: Constipation can cause urinary incontinence as the muscles and nerves that control both the bladder and bowel function are closely related. Constipation can result in the entire rectum and colon filling with stool which can put pressure on the bladder. This filling up of the colon can prevent the bladder from filling up enough or emptying properly. Constipation can also cause the bladder to contract unnecessarily leading to the feeling of needing to urinate, or being unable to stop urination. Due to these various effects, constipation can contribute to a variety of different types of incontinence including overflow incontinence and urge incontinence.

        Q: Does holding your pee cause incontinence?

        A: This is a catch 22. Holding your pee can lead to sudden urges to urinate and urge incontinence if you hold it too long. That is why emptying your bladder on a schedule can help prevent incontinence. 

        On the other hand, if one is emptying her bladder too frequently, holding your pee or ‘bladder training’ can be helpful in treating or improving symptoms of urinary urgency, frequency, and urge incontinence. Bladder training involves trying to delay urination for about 10-15 minutes after one feels the urge to go, eventually leading to the ability to delay urination for a more significant amount of time.

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