Often there is no identifiable cause for overactive bladder, but people are more likely to develop the problem as they age. Irritating substances within the bladder, such as those produced during an infection, might also cause the bladder muscle to contract. Such problems include damage to the brain, the spine, or the nerves extending from the spine to the bladder - for example, from an accident, diabetes, or neurological disease. Overactive bladder can result from physical problems that keep your body from halting involuntary bladder muscle contractions. Another name for this phenomenon is detrusor overactivity. Urgency is caused when the bladder muscle, the detrusor, begins to contract and signals a need to urinate, even when the bladder is not full. Even if you never have an accident, urgency and urinary frequency can interfere with work and a social life because of the need to keep running to the bathroom. This condition occurs in both men and women and involves an overwhelming urge to urinate immediately, frequently followed by loss of urine before you can reach a bathroom. If you feel a strong urge to urinate even when your bladder isn't full, your incontinence might be related to overactive bladder, sometimes called urge incontinence. Lung conditions that cause frequent coughing, such as emphysema and cystic fibrosis, can also contribute to stress incontinence in both men and women. In men, the most frequent cause of stress incontinence is urinary sphincter damage sustained through prostate surgery or a pelvic fracture. Many women do not experience symptoms until after menopause. Estrogen can also play some role, although it is not clear how much. As a woman gets older, the muscles in her pelvic floor and urethra weaken, and it takes less pressure for the urethra to open and allow leakage. Generally, the larger the baby, the longer the labor, the older the mother, and the greater the number of births, the more likely that incontinence will result.Īge is likewise a factor in stress incontinence. Many experts believe that women who have delivered vaginally are most likely to develop stress incontinence because giving birth has stretched and possibly damaged the pelvic floor muscles and nerves. In intrinsic sphincter deficiency, problems in the urinary sphincter interfere with full closure or allow the sphincter to pop open under pressure. In urethral hypermobility, the bladder and urethra shift downward when abdominal pressure rises, and there is no hammock-like support for the urethra to be compressed against to keep it closed. Stress incontinence is divided into two subtypes. Stress incontinence occurs when the urethral sphincter, the pelvic floor muscles, or both these structures have been weakened or damaged and cannot dependably hold in urine. The leakage occurs even though the bladder muscles are not contracting and you don't feel the urge to urinate. In more severe cases, the pressure of a full bladder overcomes the body's ability to hold in urine. Often only a small amount of urine leaks out. Although it can be emotionally distressing, the condition has nothing to do with emotion. The word "stress" actually refers to the physical strain associated with leakage. Any physical exertion that increases abdominal pressure also puts pressure on the bladder. If urine leaks out when you jump, cough, or laugh, you may have stress incontinence. Incontinence is categorized by the type of problem and, to a lesser extent, by differences in symptoms. Many things can go wrong with the complex system that allows us to control urination.
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