Risk Factors Associated with Urinary Incontinence

General Risk factors:   Gender   Age   Family history   Smoking   Some diseases

 

While overactive bladder exists in both men and women there are some unique risk factors and causes in each gender. Urinary incontinence is seen in about 11% for men aged 60-64 years, and 31% in older men. Prostate enlargement, cancer-related radiotherapy and surgery are all known causes. In contrast, urinary incontinence in women is estimated at around 53% in women over 60. Stress incontinence is the most common type and the severity of symptoms tends to increase with age.

There has been speculation about the role of heredity in urinary incontinence. And there is some clinical proof showing the children of women who have had urinary incontinence more often having urinary incontinence themselves.

Other risk factors include smoking and some diseases, such as diabetes and neurological conditions. The prevalence of both stress and urge incontinence may be significantly increased in women with diabetes or with an impaired fasting glucose. The complicating risk factors in these cases can also include age, being overweight, oral estrogen use, and microvascular complications specifically related to diabetes.

More Risk Factors Associated with Urinary Incontinence Short-term causes: medications, caffeine, urinary tract and bladder infections

Getting a little more clinical, there are several risk factors that can increase short-term urinary incontinence. These can include some anti-hypertensive drugs, such as clonidine and methyldopa. Diuretic medications may also increase the risk for urinary incontinence.

Caffeine has been implicated in urinary incontinence, which causes the bladder muscles to contract, pushing urine out of the bladder.

Also, urinary tract and bladder infections can cause irritation and swelling of the urethra and strong urges to urinate.

 

Assessment of urinary incontinence

Patients may not bring up their urinary incontinence issues with their doctor because of the embarrassment. However, the high prevalence seen in women, along with the presence of risk factors, should trigger some direct screening questions the clinician should ask the patient.

Direct screening questions for presence of urinary incontinence Urine test Ultrasound Cystoscopy Urodynamics

With risk factors in mind, direct screening questions may include a medical and patient-reported history that includes bladder habits and problems, including urinary incontinence, use of diuretics, caffeine consumption, and urinary and bladder infections.

For transient incontinence, I would recommend having the patient keep a bladder diary that includes writing down any urinary incontinence episodes, associated activities, urination times and volumes, fluid intake, and any absorbent product use. There are professional surveys which have been developed, the Urinary Distress Inventory-6 and the Incontinence Impact Questionnaire-7, which can be used and may help with getting the right information.

Assessments can include a urine test to detect the presence of infection, an ultrasound of the urethra, kidneys, and/or bladder, a cystoscopy to determine if there is damage to the urethra tissues, and urodynamic testing to assess the pressure capacity of the bladder.