Editing Urinary incontinence (section)

==Causes==
Urinary incontinence can result from both [[Urology|urologic]] and non-urologic causes. Urologic causes can be classified as either [[Urinary bladder|bladder]] dysfunction or [[Urethral sphincters|urethral sphincter]] incompetence and may include [[Overactive bladder|detrusor overactivity]], poor bladder compliance, [[urethral hypermobility]], or [[intrinsic sphincter deficiency]]. Non-urologic causes may include [[infection]], medication or drugs, psychological factors, [[polyuria]], [[hydrocephalus]],<ref>{{cite journal | vauthors = Edwards RJ, Dombrowski SM, Luciano MG, Pople IK | title = Chronic hydrocephalus in adults | journal = Brain Pathology | volume = 14 | issue = 3 | pages = 325–336 | date = July 2004 | pmid = 15446589 | doi = 10.1111/j.1750-3639.2004.tb00072.x | pmc = 8096062 }}</ref> [[fecal impaction|stool impaction]], and restricted mobility.<ref>{{cite web|title=American Urological Association - Medical Student Curriculum: Urinary Incontinence|url=http://www.auanet.org/education/auauniversity/medical-student-education/medical-student-curriculum/urinary-incontinence|website=www.auanet.org|access-date=11 January 2018}}</ref> The causes leading to urinary incontinence are usually specific to each sex, however, some causes are common to both men and women.{{citation needed|date=April 2021}}

=== Women ===
[[File:1116 Muscle of the Female Perineum.png|alt=Pelvic floor muscles in women|thumb|upright=1.5|Pelvic floor muscles in women]]
The most common types of urinary incontinence in women are [[Stress incontinence|stress urinary incontinence]] and [[Overactive bladder|urge urinary incontinence]]. Women that have symptoms of both types are said to have "mixed" urinary incontinence. After [[menopause]], [[estrogen]] production decreases and, in some women, [[urethra]]l tissue will demonstrate [[atrophy]], becoming weaker and thinner, possibly playing a role in the development of urinary incontinence.<ref name="womengov" />

[[Stress incontinence|Stress urinary incontinence]] in women is most commonly caused by loss of support of the [[urethra]], which is usually a consequence of damage to [[Pelvic floor|pelvic support structures]] as a result of [[pregnancy]], childbirth, [[obesity]], age, among others.<ref>{{Cite web|title=Urinary incontinence - Causes|url=https://www.nhs.uk/conditions/urinary-incontinence/causes/|date=2017-10-23|website=nhs.uk|language=en|access-date=2020-05-08}}</ref> About 33% of all women experience urinary incontinence after giving birth, and women who deliver vaginally are about twice as likely to have urinary incontinence as women who give birth via a [[Caesarean section]].<ref>{{cite journal | vauthors = Thom DH, Rortveit G | title = Prevalence of postpartum urinary incontinence: a systematic review | journal = Acta Obstetricia et Gynecologica Scandinavica | volume = 89 | issue = 12 | pages = 1511–1522 | date = December 2010 | pmid = 21050146 | doi = 10.3109/00016349.2010.526188 | s2cid = 18385231 | doi-access = free }}</ref> Stress incontinence is characterized by leaking of small amounts of urine with activities that increase abdominal pressure such as coughing, sneezing, laughing and lifting. This happens when the urethral sphincter cannot close completely due to the damage in the sphincter itself, or the surrounding tissue.  Additionally, frequent exercise in high-impact activities can cause [[athletic incontinence]] to develop. Urge urinary incontinence, is caused by uninhibited contractions of the [[detrusor muscle]], a condition known as [[Overactive bladder|overactive bladder syndrome]]. This type of urinary incontinence is more commonly seen in women of older age.<ref name="auto">{{Cite report |url=https://www.pcori.org/sites/default/files/PCORI-AHRQ-Nonsurgical-Treatments-Urinary-Incontinence-Women-Systematic-Review-Update-Report-August-2018.pdf |title=Nonsurgical Treatments for Urinary Incontinence in Women: A Systematic Review Update |last1=Balk |first1=Ethan |last2=Adam |first2=Gaelen P. |date=2018-08-08 |publisher=Agency for Healthcare Research and Quality (AHRQ) |issue=Comparative Effectiveness Review No. 212 |doi=10.23970/ahrqepccer212 |location=Rockville, MD |last3=Kimmel |first3=Hannah |last4=Rofeberg |first4=Valerie |last5=Saeed |first5=Iman |last6=Jeppson |first6=Peter |last7=Trikalinos |first7=Thomas}}

Also available at: https://effectivehealthcare.ahrq.gov/sites/default/files/related_files/cer-212-urinary-incontinence-updated.pdf</ref> It is characterized by leaking of large amounts of urine in association with insufficient warning to get to the bathroom in time.{{citation needed|date=April 2021}}

=== Men ===
[[File:Prostatic urethra.svg|alt=prostatic urethra|thumb|upright=1.5|The prostate with the urethra passing through it ([[prostatic urethra]])]]
[[Overactive bladder|Urge incontinence]] is the most common type of incontinence in men.<ref name="Clemens_2022">{{Cite web | vauthors = Clemens JQ | date = 3 January 2022 | veditors = O'Leary MP, Law K |title=Urinary Incontinence in Men|url=https://www.uptodate.com/contents/urinary-incontinence-in-men|work = UptoDate|access-date=8 May 2020}}</ref> Similar to women, urine leakage happens following a very intense feeling of urination, not allowing enough time to reach the bathroom, a condition called [[Overactive bladder|overactive bladder syndrome]]. In men, the condition is commonly associated with [[benign prostatic hyperplasia]] (an enlarged prostate), which causes [[bladder outlet obstruction]], a dysfunction of the [[detrusor muscle]] (muscle of the [[Urinary bladder|bladder]]), eventually causing [[Overactive bladder|overactive bladder syndrome]], and the associated incontinence.<ref name="Clemens_2022" />

[[Stress incontinence|Stress urinary incontinence]] is the other common type of incontinence in men, and it most commonly happens after prostate surgery.<ref name="Wang">{{cite journal | vauthors = Wang W, Huang QM, Liu FP, Mao QQ | title = Effectiveness of preoperative pelvic floor muscle training for urinary incontinence after radical prostatectomy: a meta-analysis | journal = BMC Urology | volume = 14 | issue = 1 | pages = 99 | date = December 2014 | pmid = 25515968 | pmc = 4274700 | doi = 10.1186/1471-2490-14-99 | doi-access = free }}</ref> [[Prostatectomy]], [[transurethral resection of the prostate]], [[prostate brachytherapy]], and [[Radiation therapy|radiotherapy]] can all damage the [[Urethral sphincters|urethral sphincter]] and surrounding tissue, causing it to be incompetent. An incompetent urethral sphincter cannot prevent urine from leaking out of the urinary bladder during activities that increase the intraabdominal pressure, such as coughing, sneezing, or laughing. Continence usually improves within 6 to 12 months after prostate surgery without any specific interventions, and only 5 to 10% of people report persistent symptoms.<ref name="Clemens_2022" />

=== Both ===
* Age is a risk factor that increases both the severity and prevalence of UI
* [[Polyuria]] (excessive urine production) of which, in turn, the most frequent causes are: uncontrolled [[diabetes mellitus]], [[primary polydipsia]] (excessive fluid [[drinking]]), [[central diabetes insipidus]] and [[nephrogenic diabetes insipidus]].<ref name="merck">{{cite web | vauthors = Maddukuri G | date = December 2022 | title = Pathophysiology of Polyuria | url = http://www.merck.com/mmpe/sec17/ch226/ch226i.html | work = [[Merck Manual]] }}</ref> Polyuria generally causes [[urinary urgency]] and [[urinary frequency|frequency]], but does not necessarily lead to incontinence.
* Neurogenic disorders like [[multiple sclerosis]], [[spina bifida]], [[Parkinson's disease]], [[stroke]]s and [[spinal cord injury]] can all interfere with nerve function of the bladder.<ref name="Thomas_2019">{{cite journal | vauthors = Thomas LH, Coupe J, Cross LD, Tan AL, Watkins CL | title = Interventions for treating urinary incontinence after stroke in adults | journal = The Cochrane Database of Systematic Reviews | volume = 2019 | issue = 2 | pages = CD004462 | date = February 2019 | pmid = 30706461 | pmc = 6355973 | doi = 10.1002/14651858.CD004462.pub4 }}</ref> This can lead to [[neurogenic bladder dysfunction]]
* [[Overactive bladder|Overactive bladder syndrome]]. However, the etiology behind this is usually different between men and women, as mentioned above.
* Other suggested risk factors include [[smoking]], caffeine intake and [[Depression (mood)|depression]]