Pathogenesis of urinary incontinence1-5
Incontinence can occur when there is a disturbance
or malfunctioning in any of the components of
micturition.
Anatomical causes
1. Detrusor hyperactivity leads to involuntary
loss of urine as soon as a sensation of
bladder fullness is felt. A sense of urgency
to urinate results, leading to the term “urge
incontinence”. It may be isolated or due to
certain associated factors.
a) Infection or inflammation of the urinary
tract can make the stretch receptors in
the bladder oversensitive and lead to
premature parasympathetic mediated
contraction.
b) Impaired bladder contractility leads to
inefficient emptying and an overactive
bladder. (detrusor hyperactivity with
impaired contractility or DHIC)6.
c) Central nervous system (CNS) disorders
leading to damage in the second frontal
gyrus and its pathways thereby leading to
loss of voluntary control over urination.
Examples include tumours, meningiomas,
and aneurysms of the frontal lobe, normal
pressure hydrocephalus, Parkinson’s
disease, multisystem atrophy.