Causes of Transient Incontinence
Cause | Comments |
|---|---|
Gastrointestinal disorders | |
Mechanism may involve mechanical disturbance of the bladder or urethra. Patients usually present with urge or overflow incontinence, typically with fecal incontinence. | |
Genitourinary disorders | |
Atrophic urethritis Atrophic vaginitis | Thinning of urethral and vaginal epithelium and submucosa may cause local irritation and decrease urethral resistance, length, and maximum closure pressure with loss of the mucosal seal. These disorders are usually characterized by urgency and occasionally by scalding dysuria. |
Foreign bodies | Bladder irritation precipitates spasm. |
Only symptomatic UTIs cause incontinence. Dysuria and urgency can prevent patients from reaching the toilet before voiding. | |
Neuropsychiatric disorders | |
Awareness of the need or ability to void is impaired. | |
Restricted mobility | |
Weakness Injury Use of physical restraints | Access to toilet is impaired. |
Systemic disorders | |
Excess urine output due to various disorders (eg, diabetes insipidus, diabetes mellitus) | Frequency, urgency, and nocturia can result. |
Drugs | |
Alcohol has a diuretic effect and can cause sedation, delirium, or immobility, which can result in functional incontinence. | |
Urine production and output are increased, causing polyuria, frequency, urgency, and nocturia. | |
Bladder neck muscle in women or prostate smooth muscle in men is lax, sometimes causing stress incontinence. | |
Bladder contractility can be impaired, sometimes causing urinary retention and overflow incontinence. These drugs also can cause delirium, constipation, and fecal impaction. | |
Detrusor contractility is decreased, sometimes causing urinary retention and overflow incontinence, nocturia due to peripheral edema, constipation, and fecal impaction. | |
Urine production and output are increased, causing polyuria, frequency, urgency, and nocturia. | |
Hormone therapy (systemic estrogen/progestin therapy) | Collagen in the paraurethral connective tissues is degraded, causing ineffective urethral closure. |
Opioids cause urinary retention, constipation, fecal impaction, sedation, and delirium. | |
Psychoactive drugs (eg, antipsychotics, benzodiazepines, sedative-hypnotics, tricyclic antidepressants) | Awareness of the need to void is blunted, and dexterity and mobility are decreased. These drugs can precipitate delirium. |