Urinary incontinence (UI) is defined as the “involuntary loss of urine so severe as to have social
and/or hygiene consequences” (NIH, 1988).
UI or unintentional loss of urine is a health problem causing inconvenience and distress to many
individuals.
Although it is perceived to be common among the elderly people, bladder problems are not
natural consequence of aging and they are not exclusively a problem of the elderly.
It is difficult to accurately determine the number of people with continence problem due to the
lack of research and the failure of the patients to request for treatment or information.
Types of UI
1) Stress Incontinence – is an involuntary loss of urine due to an increased intra-abdominal
pressure during coughing, sneezing, laughing or other physical activities that increase intra-
abdominal pressure.
2) Urge Incontinence – is the involuntary loss of urine associated with a strong desire or need to
urinate. It is usually, associated with premature detrusor muscle contractions, referred to as
detrusor instability. Although detrusor instability can be associated with neurologic disorders, it
also occurs in individuals who appear to be neurologically normal.
Urge incontinence is a result of a sudden, involuntary bladder contraction caused by
inflammation or irritation within the bladder.
This inflammation or irritation may be due to calculi, malignancy, infection or atrophic vaginitis-
urethritis.
These uncontrollable contractions can also occur when the brain centre that inhibits bladder
contractions is impaired by neurologic conditions such as stroke, Parkinson’s disease or
dementia. Urge incontinence is the most common type of incontinence in older people.
3) Mixed Incontinence – is a combination of both stress and urge incontinence. It is most
common in older women.
4) Overflow Incontinence – is the involuntary loss of urine resulting from an over-distended
bladder. It may have a variety of presentations, including frequent or constant dribbling, or urge
or stress incontinence symptoms. Overflow may be caused by an inactive or a contractile
detrusor, or bladder outlet or urethral obstruction. The bladder may be underactive or a
contractile secondary to drugs, neurologic conditions such as diabetic neuropathy, low spinal
cord injury, or radical pelvic surgery that 7 interrupts the motor innervation of the detrusor
muscle. The detrusor may also be underactive from idiopathic causes. In men, it is often related
to enlarged prostate and impacted faeces.
5) Transient Incontinence – is a result of a reversible medical condition. The patients may be
suffering from delirium, urinary tract infection, atrophic vaginitis, psychological problem (such
as depression), endocrine disorder, impaired immobility and/or stool impaction. It may be due to
drugs such as diuretics and sedatives.
6) Functional Incontinence – is the involuntary urine loss caused by factors outside the lower urinary
tract such as impairment of physical or cognitive functioning, or both. It is important to note that
immobile and cognitively impaired individuals may also have other types and causes of UI.