Causes of incontinence

Learn about the causes

It’s good to learn about what’s causing your loved one’s incontinence. It will help you understand their symptoms better, so that you can give her or him the best possible care.
If you don’t already know which type of incontinence they have, you can read about the different types here.

How the urinary system works

The causes of incontinence all affect the body’s urinary system. So let’s briefly look at how that works. Then, hopefully, you’ll see why it sometimes malfunctions. 
Your kidneys filter food waste from your blood. They then mix it with water and other waste product to form urine, which they send down tubes to your bladder. The urine leaves the kidneys via the ureters. The urine is then temporarily collected in the bladder, which is an expandable muscle sac. The muscles around the urethra are under the emptying phase relaxed and keep the urethra opened. To be able to keep continent we need support from the pelvic floor muscles and sphincter muscles. These important muscles assist in urinary and fecal continence.

Why do urinary systems malfunction?

There is no single cause of incontinence, but there are common factors. We’ve listed these below.
General causes
  • Weakening of pelvic floor muscles. These muscles keep the urethra closed. When they lose strength and supporting function, problems occur. Simple activities such as laughing, coughing, lifting or running, could cause urine to leak.

  • Urinary infections. They can lead to bladder hypersensitivity. This is when the bladder incorrectly tells the body that it needs emptying – urgently – when it's not completely full. When the infection is treated or has passed the bladder is no longer hypersensitive.

  • Being overweight. This can put extra pressure on abdominal and pelvic muscles, leading to incontinence.

  • Medications. Incontinence can be a side effect of certain medications. Some have diuretic properties that give a person the urge to urinate more frequently. 

  • Neurologic bladder disorders  - These can be due to a stroke, dementia, diabetes, Parkinson's, Multiple Sclerosis or a brain injury. Such disorders damage or interfere with nerve passageways. It prevents the right signals from traveling between the brain and the bladder. 
Female causes
  • Pregnancy/childbirth. Extra weight carried during pregnancy can put pressure on the pelvic floor muscles, ligaments and bladder. During pregnancy, hormones are released that affect the tissue and the muscles in the body, allowing it to expand as the baby grows. This allows the muscles in the pelvic floor to become softer and smoother to ease childbirth. This can make it harder for the muscles and ligaments to hold the pelvic floor organs in place. The pelvic floor muscles and ligaments are also stretched when giving birth, which can sometimes lengthen the tissues permanently. This is why pregnancy and childbirth present a risk for incontinence.

  • Menopause. With the approach of menopause, estrogen levels drop, leading to a weakening of pelvic muscles. This causes some women to have less control of their bladders.  
Male causes
  • An enlarged prostate. This can slow down, or even stop the passage of urine. It often leads to “the sudden need to go”.

  • Prostate surgery. If the muscles that control the passing of urine are damaged during prostate surgery, this can cause stress urinary incontinence – involuntary leaks when you laugh, cough or do certain physical activities.
If you’d like to know more about the causes of incontinence, speak to your doctor. Find out what you can do to help your loved one.