2023-06-20 09:44:21
There are different types of incontinence:
Urinary incontinence: the complaint of any involuntary loss of urine. Fecal incontinence: the involuntary loss of solid or liquid stool. Anal incontinence: fecal incontinence plus the involuntary loss of gas.
Causes of incontinence
Problems with mobility and obstacles. Problems with cognition. Diseases of the nervous system. Side effects of medicines. Diseases of bladder, sphincters, pelvic floor, intestines, rectum.
Incontinence is also related to:
Lifestyle (consumption of too much caffeine). Diseases such as diabetes mellitus, CVA, Parkinson’s disease, COPD and delirium. Aging. Overweight. Visual impairments. Constipation.
Forms of urinary incontinence
Urinary incontinence occurs in several forms:
Stressincontinentie
Stress incontinence, also known as drip incontinence, is the involuntary loss of urine when there is pressure in and on the abdomen. For example, when laughing, sneezing, coughing, bending over, blowing your nose, lifting heavy and moving quickly, such as during sports, drops to splashes of urine are lost. The rest of the urination pattern (micturition pattern) is normal. This type of incontinence occurs when the bladder closure system is not functioning properly. When the bladder closes, the angle between the lower part of the bladder (bladder neck) and the urethra (urethra) is important. Good support of the bladder by the pelvic floor is necessary for proper functioning. The pelvic floor consists of several muscles. A poor condition of those muscles can cause stress incontinence. A defect in the sphincter muscle can also cause stress incontinence.
Urge incontinence
Urge incontinence is the involuntary loss of urine after a sudden unstoppable urge to urinate. The client often has a (continuous) urge to urinate, immediately preceded by a sudden unstoppable urge to urinate. Patients with urge incontinence can sometimes be referred to as having an overactive bladder. An overactive bladder is a sudden strong urge to urinate (with or without incontinence) without an infection or other obvious cause. This type of incontinence involves the loss of a larger amount of urine because the bladder contracts and pushes out the urine present in the bladder. It could be that there is a problem with the bladder muscle or that the discharge is starting because a urinary reflex occurs. The urination reflex goes through the autonomic nervous system and ensures relaxation of the pelvic floor and sphincter muscle at the same time as contraction of the bladder muscle. There may also be a problem in the central nervous system (such as a disorder of the urination center in the forebrain) that triggers urination.
Mixed incontinence
Mixed incontinence is a combination of stress and urge incontinence. So involuntary loss of urine when pressure on the abdomen (exertion, sneezing) combined with an unstoppable strong urge to urinate. There is then a combination of problems in the organs mentioned in stress and urge incontinence.
Functional incontinence
Functional incontinence is involuntary loss of urine in which clients are no longer able to go to the toilet independently due to physical or cognitive limitations. The cause of the urinary incontinence is therefore not located in the bladder or sphincter muscles. The physical and cognitive limitations can be related to, among other things: side effects of medicines, disorientation, mental/physical/visual limitations, difficult clothing, long distance or obstacles in finding the toilet or insufficient help with toileting.
Overflow incontinence
Overflow incontinence is the involuntary loss of small amounts of urine from a full bladder. This form occurs when the bladder becomes enlarged and insensitive due to urine retention. The pressure in the bladder becomes so high that small amounts of urine trickle out. In overflow incontinence, the bladder muscle cannot build up enough pressure so that urination does not start. This can also occur with a narrowing of the urethra, such as with prostate enlargement, which prevents the bladder from producing the greater pressure needed.
Total incontinence
Total incontinence is the involuntary loss of urine due to continuous dribbling of urine from the urethra, both day and night. It occurs when the bladder’s closing mechanism no longer closes.
Nocturia
Nocturia is two or more urinations per night. Nighttime incontinence can occur with nocturia, but not necessarily. Often the associated type of incontinence is urge incontinence, but the amount of urine produced by the kidneys at night can also be the problem.
Forms of anal incontinence
Anal incontinence also occurs in different forms:
Anal compulsive incontinence
Anal compulsive incontinence for solid, pulpy and liquid stools has to do with the functioning of the colon, rectum, sphincter and pelvic floor. There may be defects in and around the sphincter (such as a tear in the sphincter). Or there may be a liquid stool that cannot be held by the sphincter (as in diarrhea). The latter can be the case, among other things, with excessive use of laxatives.
Passive anal incontinence
Passive anal incontinence is the loss of brown fluid. This brown fluid is produced by glands in the anal canal and leaks out. This occurs when the passage of food through the intestine is too slow (passage disorder) or due to an evacuation disorder in which the stool accumulates in the rectum and thickens. There is then an inability of the intestine to expel the stool. In the latter case we speak of ‘faecal impaction’; a constant feeling of urgency, the opening of the anus and a continuous loss of brown fluid.
Anal incontinence for flatus (intestinal gas)
This form of incontinence has to do with excessive gas production as a result of a diet or with insufficient functioning of the closing mechanism. The suffering of this type of incontinence is equivalent to incontinence for solid or liquid stools.
Double incontinence
If there is both urinary and anal incontinence, we speak of double incontinence.
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