- Stress incontinence : Laughing, coughing or sneezing may cause urinary incontinence (40-60% of diagnosed cases). When we laugh, cough, sneeze, or shout, the urethra is unable to retain the urine in the bladder. That is to say that the pressure exerted by the bladder exceeds the resistance of the urethra, when intra-abdominal pressure is increased and the contraction of the urethral sphincter is not sufficient. This is the most common type of incontinence. Urinary incontinence may also be observed when exercising or lifting weights.
- Urge urinary incontinence : The sudden desire to urinate that cannot be controlled. Urination cannot be postponed and involuntary urine leakage ensues. This disorder is known as “overactive bladder” and may be due to nervous system disorders (neurogenic) or to an unknown cause (idiopathic). The patient experiences it as a strong and urgent need to urinate that appears suddenly and cannot be postponed.
- Mixed incontinence : A combination of the 2 types above. Its cause is usually idiopathic or neurogenic, and may appear or be exacerbated by trauma, radiation, constipation or other causes of stress incontinence.
- Overflow incontinence : In certain cases, the patients are unable to empty their bladder completely; as a result, it overflows, creating the erroneous impression of incontinence. The bladder may become full to overflowing when there is an obstruction in the urethra or when the bladder is unable to make the necessary contractions for urination, i.e. when it is hypotonic. In this case we observe involuntary urine leakage.
- Total incontinence : Women who suffer from a deviation of the tubule at the urethra experience total urinary incontinence.
A particular category of incontinence is bedwetting. We know that, during the night, the kidneys produce more urine: when the body is prone, blood flow to the kidneys increases and urine production also increases accordingly.
When we are lying down and sleeping, the muscular relaxation that ensues facilitates urine leakage.
Many medical conditions also increase the risk of urine leakage overnight. These include diabetes, urinary tract infections, urinary tract calculi, especially bladder calculi, as well as anatomical anomalies in the area.
Lastly, based on another classification based on the quantity of urine that remains in the bladder following micturition, we may divide this type of incontinence into the type that does not leave any residue of urine after micturition and the type that leaves a large residue.
These types of urinary incontinence are due to overflowing.
That means that the patient may often urinate without their bladder ever being completely empty. Most of the time, the patient is not aware of the fact that his/her bladder does not empty.
Kindly contributed by Urologist – Andrologist Surgeon, Dr Charalambos P. Asvestis