GYNECOLOGY:
persistent incontinence
Urinary incontinence can also be a persistent condition caused by some underlying physical problem — weakened pelvic floor or bladder muscles, neurological diseases, or an obstruction in the urinary tract.
Factors that can lead to chronic incontinence include:
- Pregnancy and childbirth. An estimated two to seven out of 10 pregnant women experience stress incontinence. This is largely in part due to hormonal changes and an enlarging uterus. In addition, the stress of a vaginal delivery can weaken the pelvic floor muscles and the supporting structures to the uterus, bladder and rectum. This can eventually lead to a dropping of the pelvic organs (pelvic organ prolapse) or incontinence.
- Changes with aging. As a woman ages so does her bladder muscle, which can lead to a decrease in the bladder's capacity to store urine and an increase in overactive bladder symptoms. Additionally, women produce less of the hormone estrogen after menopause, a decrease that can contribute to bladder irritability and overactivity.
- Hysterectomy. In women, the bladder and uterus lie close to one another and are supported by the same muscles and ligaments. Any surgery that involves a woman's reproductive system — for example, removal of the uterus (hysterectomy) — runs the risk of damaging the supporting pelvic floor muscles, which can lead to incontinence.
- Painful bladder syndrome (interstitial cystitis). This rare, chronic condition, which affects women more often than men, can be associated with an inflammation of the bladder wall. It occasionally causes urinary incontinence, as well as painful and frequent urination.
- Bladder cancer or bladder stones. Incontinence, urinary urgency and burning with urination can be signs and symptoms of bladder cancer and also of bladder stones. Other signs and symptoms include blood in the urine and pelvic pain.
- Neurological disorders. Multiple sclerosis, Parkinson's disease, stroke, a brain tumor or a spinal injury can interfere with nerve signals involved in bladder control, causing urinary incontinence.
- Obstruction. A tumor anywhere along the urinary tract can obstruct the normal flow of urine and cause incontinence, usually overflow incontinence