Urinary Incontinence

Definition

Urinary incontinence (UI) is the involuntary leakage of urine, representing a significant medical and social issue. It can result from multiple urological, neurological, or systemic causes.

Epidemiology

• Affects 25–45% of women and 5–15% of men, prevalence increasing with age
• More common in elderly population and women with parity or pelvic floor trauma
• Significant impact on quality of life, social interaction, and mental health
• Underreported due to embarrassment and social stigma

Etiology

• Stress urinary incontinence: pelvic floor weakness, post-partum, post-prostatectomy
• Urge incontinence: overactive bladder, neurological disorders
• Mixed incontinence: combination of stress and urge
• Overflow incontinence: bladder outlet obstruction, underactive detrusor
• Functional incontinence: mobility, cognitive impairment, environmental barriers
• Medications: diuretics, alpha-blockers, anticholinergics

Pathophysiology

• Stress UI: urethral sphincter incompetence, loss of pelvic floor support → leakage on increased intra-abdominal pressure
• Urge UI: detrusor overactivity → involuntary bladder contractions
• Overflow UI: impaired detrusor contraction or obstruction → bladder overdistension
• Functional UI: normal urinary tract but impaired access to toilet
• Mixed UI: combination of mechanisms leading to complex symptoms