Bladder and incontinence

Bladder and incontinence

Urinary incontinence is defined as involuntary loss of urine and can commonly occur in the elderly. The bladder collects the urine arriving from the kidneys via the ureter. The wall of the bladder is composed of epithelium and a smooth muscle layer named the detrusor. The pelvic floor and the proximal and distal sphincters keep the urine in the bladder, until the urine volume reaches a certain level and the miction reflex is turned on.

The four main problems causing incontinence are:

  • overactivity of the detrusor (urge incontinence).
  • defective closure mechanisms (stress incontinence)
  • overflow bladder (urinary retention)
  • cognitive or motor disorders (enuresis)

Combinations of urge incontinence and stress incontinence are very common. Patients with serious cognitive disorders often display a combination of faecal and urinary incontinence, because of an analogous control mechanism. Good anamnesis and physical examination is necessary in order to establish the right diagnosis. The causes of the incontinence can be transient or irreversible.

Read more about incontinence and therapy in the Farmacotherapeutisch Kompas.




Stress incontinence is most prevalent among