Urinary Incontinence

Incontinence is the inability to retain faecal matter or urine until the desired moment of discharge. In contrast, a bladder emptying disorder impedes voluntary emptying of the bladder.

It is the bladder’s function to collect urine that is continuously produced by the kidneys, and to empty itself when full. An infant has no voluntary control over this function of the bladder. Infants must therefore be toilet trained before they can gain control over the bladder’s emptying process. 

Unfortunately, there are many causes of disorders associated with bladder filling or voiding. Urinary incontinence is classified into several forms. Stress incontinence results in the involuntary loss of urine during day-to-day physical stresses, such as coughing, laughing and lifting objects. At times, sporting activities have to be given up completely if bladder closure no longer functions. This predominantly affects women who then avoid many activities for fear of uncontrollable urine loss, which can be extremely embarrassing.

With urge incontinence, the need to urinate comes on suddenly, almost like a command, and often the bladder will empty itself before one reaches the toilet. If the bladder fills up as a result of a vaginal prolapse or nerve damage, e.g., diabetes or a stroke, without an accompanying urge to urinate, there will be continuous loss of urine from the so-called overflow bladder.

Urinary incontinence in men

Bladder disorders in males consist mostly of frequent voiding of urine and a command-like urge to urinate as a result of an enlarged prostate. An involuntary loss of urine (i.e. incontinence) can arise following a radical prostatectomy. Proper diagnosis requires a urodynamic evaluation with video urodynamics, a voiding cystourethrogram and uroflowmetry. A rectal exam, introital ultrasound and rectal ultrasound of the prostate are carried out.