Urinary Incontinence in Women: Causes and When to See a Doctor

Urinary incontinence in women is the involuntary leakage of urine that creates social or hygienic problems. This wording was given in 1988 by the International Continence Society (ICS), and in 2002 its terminology committee expanded the definition to any condition leading to involuntary leakage of urine. Below are the types, causes, and evaluation pathway.

What urinary incontinence in women is and what types exist

Urinary incontinence (UI) is loss of control over urination; the disorder ranges from a minor problem to a condition that strongly affects daily life. In the diagnostic structure, stress incontinence accounts for 49%, urge incontinence for 22%, and mixed incontinence for 29%.

• Stress — leakage during exertion, coughing, sneezing, laughing, lifting heavy objects, or other physical activity.
• Urge — leakage immediately after a sudden, strong urge to urinate.
• Mixed — a combination of stress and urge components.
• Overflow incontinence (chronic urinary retention) — the bladder does not empty completely, which causes frequent dribbling.
• Total — the bladder does not retain urine, and leakage occurs continuously or frequently.

According to ICS data, stress incontinence occurs in 34–38% of women in the United States and European countries. In domestic studies, symptoms of involuntary urine leakage were noted by about 38.6% of women.

Main causes of urinary incontinence in women

The cause is determined by the type of disorder. Stress incontinence develops with insufficient support of the urethra and/or bladder neck, which leads to urethral hypermobility, or with internal sphincter deficiency. It is based on weakening or damage to the muscles that hold urine — the pelvic floor muscles and the urethral sphincter. Urge incontinence is associated with detrusor overactivity, the muscle that controls the bladder; sometimes it proves to be a sign of a urinary tract infection or occurs in neurological conditions such as multiple sclerosis and spinal cord injuries.

Overflow incontinence is caused by an obstruction or blockage in the bladder; among the causes are tumors, kidney stones, diabetes, and certain medications. Total incontinence may result from congenital bladder pathology, spinal cord injury, or a fistula — a narrow channel between the bladder and an adjacent area. Transient incontinence is distinguished separately — leakage against the background of a temporary situation, such as an infection or a new medication; it resolves after the cause is eliminated.

Urinary incontinence after childbirth: why it occurs

Pregnancy and vaginal delivery increase the likelihood of incontinence and can weaken the muscles that control the outflow of urine from the bladder.

Urinary incontinence in older women

Age is among the risk factors: over the years, the muscles of the urinary tract weaken, and holding urine becomes more difficult. Urge incontinence is more common in older people. At the same time, incontinence is not an inevitable part of aging, and the condition can improve with proper treatment.

How a doctor determines the cause of involuntary urination

Diagnosis begins with a consultation: the doctor asks about symptoms and may perform a gynecological examination. One of the basic tools is a bladder diary, which records the volume and time of fluid intake, the time and volume of urinations, and leakage episodes; records are kept for several days before the appointment.

Next, urine and blood tests are possible, urine culture for flora with antibiotic sensitivity testing, assessment of residual urine, functional tests and questionnaires, imaging methods, and comprehensive urodynamic testing. If necessary, the doctor refers the patient to a specialist.

When to see a doctor

You should see a doctor for any type of urinary incontinence. This is a common problem, and talking about symptoms does not require embarrassment: a consultation becomes the first step toward selecting a way to control the manifestations. The first point of contact is a general practitioner, who, if necessary, refers to a specialist.

Urinary incontinence by itself is not a reason to call an ambulance. 103/112 — if involuntary urination occurs against the background of a condition considered life-threatening: stroke, heart attack, or severe trauma.

This material is for reference purposes and does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer