Urinary Incontinence in Adults

• Published in: Surgery (Oxford) 2002-11, Vol.20 (11), p.258-264
• Main Authors: Chapple, CR, Goonesinghe, Satish K, Bryan, N
• Format: Article
• Language: English
• Subjects: adults; urinary incontinence; urology
• ISSN: 0263-9319; 1878-1764
• DOI: 10.1383/surg.20.11.258.14535

Urinary incontinence is defined by the International Continence Society (ICS) as ‘a condition where involuntary loss of urine is a social or hygienic problem and is objectively demonstrable’. It represents failure to store urine during the filling phase, either as a result of an abnormal detrusor (overactive, oversensitive) or an abnormal sphincter complex (i.e. too weak). It is a common and distressing problem and it has far-reaching effects on the life of an individual, with functional, psychological and social sequelae. It affects about 3.5 million people in the UK, though the figure may be as high as 10 million because many sufferers do not seek help despite, or because of, the social embarrassment caused. The elderly are particularly vulnerable, and women are affected more than men. The prevalence of treatment for incontinence in the UK is 8.5% for women and 1.6% for men in the 15–64 years age group, while the figures for those 65 years and over are 11.6% for women and 6.9% for men. Urine loss is either urethral or extra-urethral; extra-urethral loss is secondary to abnormal anatomy (e.g. ectopic ureter, rectovesical or vesico-vaginal fistulae). As LUT function is dependent on neural inputs from the central nervous system as well, neurological conditions (e.g. multiple sclerosis, Parkinson's disease or spinal cord disease/injury) commonly cause incontinence. Urinary incontinence sometimes heralds the presence of such a disorder.