Search Knowledge Base by Keyword
Incontinence: Urinary and Fecal
Incontinence is the involuntary loss of bladder or bowel control.
Stress Urinary Incontinence (SUI):
- Involuntary loss of urine secondary to an increase in intra-abdominal pressure (coughing, sneezing, laughing, lifting, exercise, or transitional movements).
- Usually only a small volume of urine loss.
- Urethra (where urine exits) may have too much mobility and does not close completely (decreased urethral closure pressure).
- Generally caused by a weak pelvic floor.
- Pelvic floor strengthening (Kegels) have strongest evidence in research to be an effective treatment method.
Urge Urinary Incontinence (UUI):
- Sudden, involuntary loss of bladder control secondary to a strong and overwhelming urge to go to the washroom.
- You will have urine loss before you are able to make it to the toilet (inability to delay voiding).
- There can be a small amount of urine loss or a complete emptying of the bladder as a result of urge incontinence.
- May be caused by detrusor (bladder muscle) instability, weak or tight pelvic floor muscles, or an upregulated sympathetic nervous system.
- Bladder irritants must be taken into consideration.
- Urge inhibition techniques can helpful.
- The bladder doesn’t empty normally and becomes very full (distended bladder).
- Constant loss of small amount of urine (dribbles).
- The bladder may also never feel completely empty.
- This can be seen with conditions such as diabetes, Parkinson’s, and after radiation to the pelvis.
- Involuntary urinary leakage which is associated with impairment of cognitive or physical function (broken hip), psychological unwillingness (dementia), or environmental barriers to the toilet.
- Little changes can make a big difference (e.g. Velcro fasteners on pants instead of buttons, bedside commode and/or overall improvement in mobility and strength).
- Involuntary urine loss associated with increases in intra-abdominal pressure (stress incontinence) and with an intense urge to void (urge incontinence).
- It is very common to have mixed incontinence.
Fecal Incontinence (FI):
- Inability to control your bowel movements, causing involuntary leakage of stool (feces) from your rectum.
- Also called bowel or anal incontinence.
- Can be occasional leakage while passing gas.
- Can be complete loss of bowel control.
Post-prostatectomy Incontinence (PPI):
- Involuntary urine loss following prostate surgery.
- Can be related to stress, urge, or mixed incontinence.
Pelvic floor muscle training is the first line treatment for urinary incontinence in women with Level 1, Grade A evidence of having incontinence. This is the highest level of evidence, meaning pelvic floor muscle training should be the first step in a treatment plan.