Risk factors

These are a series of circumstances that can favour the appearance of urinary incontinence

Degree of physical fitness, motivation and state of mind all have a positive influence on bladder control. Therefore, the more active the person, the more physical exercise they do and the better their psychological state, the better their bladder control. In the same way, maintaining regular bowel movements and avoiding constipation also contributes to having better bladder control.

 Natalia Gennaro, expert gynecologist, specialised in laparoscopic surgery and the pelvic floor

Age: Often around or above the age of 60. During this period, neurological changes happen between the brain and the spinal cord, reducing the coordination between bladder contractions and the sphincters.

MenopauseAfter the menopause, estrogen levels decline and the particularly sensitive tissues, such as the vagina, bladder and urethra, begin to lose their vitality, which is called stunting, making them more vulnerable to dysfunction, irritation, infections, etc.

Pregnancy: During pregnancy, the volume of blood that must be filtered increases and bladder capacity decreases, which therefore increases the frequency of urination. Women need to empty their bladders more often. Loss of urine is also particularly common during the last trimester, when pressure on the bladder and pelvis increases and the pelvic floor muscles and nerves are elongated or compressed, altering their functions.

Vaginal childbirth: When the fetus passes through the birth canal, this can compress, elongate or sometimes even break the nerves, vessels, muscles or even the pelvic organs. All of these traumas can provoke immediate or delayed urinary symptoms.

Multiple medication: Large quantities of medicine can alter the urinary function and provoke symptoms of urgency or incontinence. Diuretics remove excess water, increasing the volume of urine. Sedatives, antidepressants, anti-inflammatories can all interfere with bladder contractions. It’s important to relate these symptoms to the initiation of a certain medicine. 

Neurological diseases: Certain neurological diseases can provoke symptoms of incontinence or urinary retention. For example, Multiple Sclerosis can cause a loss of coordination in the muscles and the ability to contract, provoking incontinence. Parkinson’s can cause the muscles to shake and become rigid, leading to both urinary and faecal incontinence. A stroke happens when the flow of blood to the brain is interrupted by a blood vessel occlusion. The symptoms produced in the body depend on which area of the brain has been affected. The patient may experience paralysis or weakness, the feeling of urination may disappear or they may experience urinary retention, incontinence or both.

Diabetes: Advanced diabetes can lead to bladder damage, usually due to a nerve injury, loss of urge to urinate or loss of muscle control.

Previous pelvic surgery: The unfortunate effects of pelvic surgery can result in damage or weakness of the pelvic muscles, tissues or nerves. Symptoms of an overactive bladder or urinary incontinence can occur after a hysterectomy, bladder suspension or oncological pelvic surgery.

Previous pelvic radiation: After radiation, the tissues transform and lose their specificity. Problems such as a urinary infection, abnormal sexual response, impaired bladder emptying or urinary incontinence may occur.

Chronic urinary tract infection: Bacteria can cause a urinary infection which can then lead to an irritable bladder. Recurrent infections can reduce the muscle tone, resulting in incontinence. 

Bladder cancer: Cancer can provoke bladder irritation and cause symptoms such as an overactive bladder and urinary or urge incontinence.

Excess weight: Excess weight increases the pressure on your bladder. Obesity can reduce the flow of blood to this area of the body, leading to damage in the nerve connections of the bladder. Every 5 to 10% of weight lost improves the pressure on the bladder and symptoms of incontinence.

Certain occupations: Certain types of occupations, in which you’re not able to maintain a healthy rhythm of fluid intake and trips to the bathroom, can provoke or aggravate symptoms of an overactive bladder or urinary or urge incontinence.