Chapter 6 – The Bladder and the Pelvic Floor

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Other types of incontinence

Functional incontinence relates to a physical, intellectual or environmental issues that can be a contributing cause of incontinence in a person with normal bladder function.(22) Continuous urinary incontinence is the complaint of a continuous leakage. This can be caused by urethral sphincter weakness or extra-urethral incontinence. Unconscious urinary incontinence is the complaint of involuntary loss of urine that is unaccompanied by either urge or stress. It may be caused by detrusor overactivity, urethral sphincter weakness or extra-urethral incontinence. Nocturnal enuresis is the complaint of an involuntary loss of urine occurring during sleep. In 1-2 per cent of children with enuresis this persists into adulthood (primary nocturnal enuresis). Treatment options include fluid modulation, bladder volume training, bed wetting alarm system, or medications (e.g. desmopressin, imipramine, anticholinergic therapy). Postmicturition dribble is the complaint of an involuntary loss of urine immediately after passing urine. Causes, such as a urethral diverticulum, urethral obstruction, or vaginal entrapment need to be considered. Overflow incontinence refers to leakage of urine associated with incomplete bladder emptying. This can be as a result of impaired detrusor contractility (e.g. idiopathic, diabetes mellitus, after epidural anaesthesia, after major pelvic surgery) or with bladder outlet obstruction caused by prostatic enlargement, urethral stricture or tumour.

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