Bladder Disorders
There are a number of different types of urinary incontinence:-
Overactive bladder
Individuals experience urgency with the sensation that micturition is imminent with or without incontinence. 85% of older people presenting with urinary incontinence have an overactive bladder or detrusor instability.
Stress urinary incontinence
Individuals experience an involuntary small leakage of urine on effort that increases the intra abdominal pressure such as, exertion, sneezing, coughing, laughing and during sexual intercourse. Most common type of urinary incontinence in younger women. Stress urinary incontinence also occurs in post-menopausal women due to age related physiological changes due to a reduction in oestrogen levels, and impairment to the contractability of the pelvic floor following labour and vaginal births.
Overflow incontinence or voiding difficulty
Occurs when there is an impediment to the normal smooth emptying of the bladder. More common in men. The most common cause of outflow obstruction is benign prostatic enlargement other causes can be prostatic carcinoma, urethral stricture. Constipation can cause outflow obstruction in both men and women. Common symptoms suggestive of outflow obstruction are:-
Mixed urinary incontinence
Caused by a combination of both bladder and pelvic floor dysfunction, common in multiparous women after the menopause.
Functional incontinence
Caused by conditions such as cognitive impairment, immobility, and those individuals who are dependant on asking others to assist them with their toileting needs.
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