What causes urinary incontinence in the elderly?

Written by Zhou Yan
Geriatrics
Updated on February 08, 2025
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Urinary incontinence in the elderly varies due to different mechanisms and types, with the two most common categories being genuine urinary incontinence, which is due to neurogenic bladder dysfunction or overactive detrusor muscles, damage to the urethral sphincter, or loss of bladder storage function. These are commonly seen in conditions like chronic stroke, dementia, Parkinson's disease, and psychiatric diseases. The other major category is caused by relaxation of the urethral sphincter or pelvic floor muscles surrounding the urethra, leading to reduced urethral pressure. Incontinence in this category may occur when negative pressure increases, such as during coughing, sneezing, straining during bowel movements, or changing body position. This type of urinary incontinence is more common in elderly women and in elderly men who have had prostate removal, leading to damage to the external urethral sphincter.

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Written by Zhang Shu Kun
Traditional Chinese Medicine
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Which part to massage for urinary incontinence

In cases of urinary incontinence, massaging acupoints such as Zusanli (ST36) and Shenshu (BL23) can effectively alleviate the condition, but this does not cure it. It is recommended to visit a formal hospital and follow the doctor's guidance for symptomatic treatment to achieve a cure. It is crucial to seek timely treatment to prevent the condition from worsening, which can be difficult to cure and may affect daily life. It is advised to engage in more physical activities regularly, as this can help strengthen the body's resistance. Doing exercises such as squats, push-ups, and sit-ups can also effectively help relieve symptoms of urinary incontinence.

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Written by Chen Feng
Urology
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What is the difference between genuine urinary incontinence and pseudo urinary incontinence?

Genuine urinary incontinence generally occurs due to incomplete closure of the urethral sphincter, or due to insufficient urethral closure pressure. As a result, patients will show continuous leakage of urine from the urethra or involuntary urine discharge from the urethra when there is an increase in intra-abdominal pressure, such as during sneezing, coughing, or performing strenuous physical activities. Genuine urinary incontinence includes both continuous and stress urinary incontinence. Pseudo urinary incontinence is generally due to urethral stricture, commonly seen with conditions such as prostatic hyperplasia or urethral stones. The urethral stricture prevents urine from being expelled from the bladder. When the bladder becomes overly full, urine overflows through the urethra, a condition also known as overflow incontinence.

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Written by Du Rui Xia
Obstetrics
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Can you sit for a long time with postpartum urinary incontinence?

When postpartum urinary incontinence occurs, it is not advisable for the mother to sit for extended periods. This is because urinary incontinence in women is primarily due to pelvic floor muscle dysfunction. Sitting for long periods is detrimental to the recovery of pelvic floor muscle function. It is recommended that women pay attention to rest, avoid prolonged walking or standing, and also avoid sitting for long periods. Rest is important, as is ensuring adequate sleep and enhancing nutrition by consuming foods rich in protein and vitamins. It is advised to seek early pelvic floor rehabilitation training at a hospital and to adhere to the rehabilitation exercises. Generally, good recovery can be achieved within six months.

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Written by Wang Shuai
Urology
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How many types of urinary incontinency are there?

Urinary incontinence is currently mainly divided into stress urinary incontinence, urge urinary incontinence, overflow urinary incontinence, and true urinary incontinence. The main symptom of stress urinary incontinence is urine leakage from the urethra during coughing, sneezing, laughing, or jumping rope. Urge urinary incontinence is commonly seen in acute bladder inflammation, people with diabetes, and those with sclerotic bladder necks, leading to situations of urge incontinence. The main manifestation is a sudden strong urge to urinate, requiring immediate action to urinate; if not managed in time, urine will leak from the urethra. Overflow incontinence, commonly found in lower urinary tract obstructions, especially in elderly men with prostate enlargement, causes overflow incontinence due to urethral blockage, characterized by a distinct feeling of fullness in the lower abdomen.

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Written by Chen Yu Fei
Neurosurgery
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What should I do if spinal bifida causes fecal incontinence?

When patients with spina bifida experience fecal incontinence, it generally indicates that the condition is quite severe and often requires prompt treatment. Many of these patients have an overt form of spina bifida. In such cases, a localized bulging mass can be found at the lower back, possibly accompanied by protruding spinal cord, meninges, and nerve roots. For these patients, early surgical intervention is recommended. Clinically, surgery is usually advised to remove the bulging mass and effectively separate and release the adhered nerve roots. If possible, it is best to reposition them back into the spinal canal to achieve the surgical treatment goals. Such surgeries are generally recommended to be performed at well-known, top-tier hospitals locally.