When the pelvic floor muscles are weakened and cannot keep the urethra completely closed, stress incontinence occurs. Sudden pressure on the bladder may cause urine to leak out of the urethra. A cough or sneeze can trigger it. The following can cause the pelvic floor muscles to lose some of their strength:
Menopause - when estrogen levels drop the muscles may get weaker.
A hysterectomy - surgical removal of the uterus (womb).
Some other surgical procedures.
Causes of urge incontinence
Urge incontinence happens when the person's bladder contracts prematurely, usually before it is full. The sufferer typically cannot get to a toilet in time. Experts believe it is caused by something going wrong with the signaling system between the brain and the bladder, but they are not really sure.
Most cases of urge incontinence are diagnosed as overactive bladder syndrome because no specific cause was found. The following causes of urge incontinence have been identified:
Cystitis - inflammation of the lining of the bladder. It usually occurs when the normally sterile urethra and bladder are infected by bacteria and become irritated and inflamed. Cystitis is fairly common and can affect both men and women of all ages - it is more common in women.
CNS (central nervous system) problems - examples are multiple sclerosis, stroke and Parkinson's disease.
An enlarged prostate - the bladder may drop and the urethra could become irritated.
Causes of overflow incontinence
This happens when there is an obstruction or blockage to the bladder. The patient may not be able to empty the bladder completely after urination, pressure builds up behind the obstruction, causing leakages. The following may cause an obstruction:
An enlarged prostate gland.
A tumor pressing against the bladder.
Urinary incontinence surgery which went too far.
Causes of total incontinence
This occurs when the bladder cannot hold any urine and the patient either leaks all the time or frequently. The following can cause total incontinence:
An anatomical defect the person has had from birth.
A spinal cord injury which messes up the nerve signals between the brain and the bladder.
A fistula - a tube (channel) develops between the bladder and a nearby area, most typically the vagina.
The following may also sometimes cause urinary incontinence:
Some medications - especially some diuretics, antihypertensive drugs, sleeping tablets, sedatives, and muscle relaxants.
Alcohol - if a person drinks a large quantity of alcohol the bladder and the muscles around it will relax, plus the individual may become less aware of when it is time to urinate. Alcohol is also a diuretic and a bladder stimulant. In general, any amount of alcohol will relax the muscles linked to urinary control to a certain extent.
Other drinks and foods - some sodas (carbonated drinks), tea, coffee, artificial sweeteners, corn syrup can aggravate the bladder and trigger episodes of incontinence. For some people, incontinence may be triggered by foods with certain spices, sugar, acid (citrus and tomatoes). Caffeine is a diuretic and a bladder stimulant.
Urinary tract infection - this can irritate the bladder, triggering strong urges to urinate which may sometimes result in episodes of incontinence.
Dehydration - if a person becomes dehydrated the urine can become highly concentrated - the concentrated salts can irritate the bladder and cause incontinence.