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Continence Management

Loss of bladder control – understanding urinary incontinence

There are a number of reasons why men and women of all ages suffer with bladder control problems. To understand the different causes, it’s important to understand how the bladder works.

Urinary incontinence – also known as “leaking urine” or “bladder leakage” – describes the accidental and involuntary leakage of urine. This can happen to men and women of any age although there are sometimes different causes for males and females.

Women are far more likely to experience urinary incontinence than men. This is because of anatomical differences in the pelvic region and changes induced by pregnancy and childbirth. While urinary incontinence is not an inevitable part of ageing, the prevalence does increase in line with age.

How the bladder works

To understand the different causes for bladder problems and the differences faced by between men and women, it is essential to understand how a healthy bladder functions.

The bladder is a balloon-shaped organ – a muscle in fact -- that sits in the pelvis, supported and held in place, by the pelvic floor muscles. Its purpose is to store and release urine.

A tube, called the urethra, connects the bladder to the genitals, from where the urine is passed. Ring-like muscles, called sphincters, control the urethra, keeping it closed so urine doesn’t leak from the bladder before it’s ready to be released. Hormones work to help keep the lining of the bladder and urethra healthy.

The bladder muscle relaxes when it fills with urine and contracts when it’s time to urinate. Nerves carry signals from the bladder to the brain – to let the brain know when the bladder is full - and from the brain to the bladder – to let the bladder know when it’s time to urinate.

For the urinary system to do its job effectively, muscles and nerves must work together to hold urine in the bladder and then release it at the right time. If either the muscles or the nerves are impaired, this could lead to incontinence.

Weak pelvic muscles cause most bladder control problems. If the bladder sags out of position, it can stretch the opening to the urethra. Nerve damage can also result in urinary incontinence. Damaged nerves can send signals to the bladder at the wrong time, causing the bladder to release urine without warning. When damaged nerves stop sending signals at all, so the brain can't tell when the bladder is full. Nerves can be damaged by diseases or trauma. Diseases and conditions that can damage the nerves include diabetes, Parkinson's Disease, multiple sclerosis and strokes.

As well as weak muscles and nerve damage, bladder control problems can be caused when medicines dull the nerves.

Weak pelvic muscles cause most bladder control problems. If the bladder sags out of position, it can stretch the opening to the urethra. Damaged nerves can also result in urinary incontinence sending signals to the bladder at the wrong time, meaning the bladder pushes out urine without any warning. Damaged nerves can also stop sending signals at all, meaning the brain cannot tell when the bladder is full.

Nerve damage can be caused through diseases such as diabetes, Parkinson's disease, multiple sclerosis and a stroke. Bladder control problems can also be caused through medicines which dull the nerves or sudden traumas.