Involuntary urine leakage is termed incontinence. This may be due to temporary causes or more persistent causes. Incontinence is not disease or condition, but a symptom of a disease or condition. Women of all age groups may encounter bladder leakage; men are more likely to encounter bladder leakage in their mid and later years, but it may occur at any age for men as well. Bladder leakage can be a cause of embarrassment for many people, but it is not an unusual condition. It is also a symptom of an underlying problem. Sharing the fact of your incontinence with your health-care provider, he can begin to determine the underlying cause and initiate appropriate treatment.
There are a number of body systems that must work together to maintain good bladder health and prevent bladder leakage. Understanding the many processes involved is helpful in understanding bladder leakage issues. The bladder is much like a balloon in that its walls will stretch to accommodate the in-flow of urine from the kidneys via two tubes known as the ureters. Except during the act of voiding (urinating), the muscles of the bladder are normally relaxed. When you urinate, the muscles of the bladder contract to empty the urine. Leading from the bladder to the outside of the body is a tube called the urethra. The urethra has sphincter muscles which stay contracted to prevent urine leakage; during urination these muscles relax. Another set of muscles involved in bladder control are the pelvic floor muscles, which hold the bladder in place. The nervous system is also involved in bladder control. Nerve signals from the bladder tell the brain when the bladder is full; nerve signals from the brain tell the bladder when it is time to void. The endocrine system also plays a part in the ability to control your bladder. Proper hormonal balance maintains the health of the lining of both the bladder and urethra.
You may experience bladder leakage if there is change or disruption in any of the systems involved in bladder control. Weak pelvic muscles are one of the primary causes of bladder leakage. Not all pelvic muscle weakness is due to pregnancy/childbirth, but those conditions do put stress on the pelvic floor. Kegel exercises work to re-strengthen the pelvic muscles, which can result in a return of bladder control. Nerve damage, usually from disease or trauma, can result in a difference in the way the brain and bladder signal each other. Sometimes the nerve damage is extensive enough that the signals stop altogether. Some diseases and afflictions that may cause the nerve damage leading to loss of bladder control include Parkinson's, diabetes mellitus, stroke, multiple sclerosis and Alzheimer's. Trauma causing such nerve damage might be from pelvic or back injury, pelvic or back surgery and radiation therapy. Some medications may also affect the nerve signals to and from the brain and bladder, weakening the signal. Medications may also interfere with the proper function of the muscles involved in bladder control. Alcohol intake can affect the nerve signals, causing bladder leakage. Water pills (diuretics) and caffeine cause the body to produce urine more quickly than normal, resulting in the bladder becoming full faster. A urinary tract infection can lead to temporary bladder leakage. The process of aging can affect the musculature involved in bladder control, making bladder leakage a problem for men and women alike. Constipation can cause temporary incontinence because when the rectum is full of stool, it presses against the bladder, causing the nerves to be overactive. Enlargement of the prostate gland in men can cause several difficulties with normal urination, including bladder leakage. Bladder cancer/bladder stones may cause bladder leakage along with burning upon urination, urgency to void and sometimes blood in the urine. Some women experience bladder leakage after a hysterectomy due to possible muscle or nerve damage from the surgery, since the uterus and bladder are in such close proximity. The decrease in the production of estrogen in women after menopause can contribute to bladder leakage. This hormone is involved in keeping the lining of the bladder and urethra healthy. When its production decreases, it can affect the ability of these muscles to work properly.