Overview of Urge Incontinence
Urge incontinence is characterized by a sudden uncontrollable urge to urinate and frequent urination. It is often necessary to use a bathroom as frequently as every 2 hours, and bed-wetting is common.
With urge incontinence, the bladder contracts and squeezes out urine involuntarily. Sometimes a large amount of urine is released. Accidental urination can be triggered by
- sudden change in position or activity,
- hearing or touching running water, and
- drinking a small amount of liquid.
Causes of Urge Incontinence
Two bladder abnormalities commonly cause urge incontinence. The most common is a neurogenic bladder (overactive type), which is caused by brain injury or spinal cord injury or disease that interrupts nerve conduction above the sacrum and results in loss of bladder sensation and motor control.
There are several neurological diseases and disorders associated with a neurogenic bladder, including the following:
- Alzheimer's disease
- Diabetes mellitus
- Multiple sclerosis
- Parkinson's disease
- Ruptured intervertebral disk
- Traumatic brain injury or upper spinal cord injury
- Tumors located in the brain or spinal cord
Chronic urinary tract infection, bladder stones, and polyps can irritate the bladder and cause detrusor muscle instability, leading to urge incontinence. Detrusor muscle instability without a known cause is also common. It has been suggested that, in these cases, an unidentified dysfunction in muscle or nerve tissue is responsible.
Diuretics increase the amount of urine released from the body. They are commonly used to treat high blood pressure (hypertension) and fluid build-up in the body (edema). Rapid-acting diuretics increase the urgency and frequency of urination in some people, especially the elderly and bedridden. Modifying dosage may alleviate symptoms.
Other causes for urge incontinence include atrophic vaginitis (low estrogen levels can weaken the vaginal lining leading to urethral and bladder irritability and urgency) and diet. Caffeine (e.g., in coffee, tea, chocolate), carbonated beverages, spicy foods, and tomato-based foods can irritate the bladder and cause detrusor muscle instability in some patients, resulting in urge incontinence.