Urgent urinary incontinence

Urgent urinary incontinence is urinary incontinence that occurs as part of overactive bladder syndrome. It is associated with urgency, i.e. the compulsion to urinate, which the patient must comply with unconditionally. In contrast to the physiological compulsion to urinate, the intensity of which increases continuously, the intensity of the urgency is sudden.

Causes of urge incontinence
Urge incontinence can be primary, secondary or of unknown cause.

Primary
Idiopathic urge incontinence is thought to be caused by pathological activation of the bladder detrusor either at the level of neural triggering of the micturition reflex (neurogenic theory) or at the level of the muscle cells themselves (myogenic theory).

Secondary
Secondary urgent incontinence occurs post-infection, as a result of tumor growth, post-irradiation, post-surgery, as a result of a foreign body, etc.

Types of emergencies
When pathological contractions of the bladder detrusor are detected during filling cystometry, we speak of motor urgency with a hyperactive detrusor. The cause may be a suprasacral neurological lesion ( detrusor hyperreflexia, neurogenic hyperactivity ), difficult urine outflow ( infravesical obstruction ) of an organic (congenital or acquired) or functional type (functional urethral narrowing, detrusor-urethral dyssynergy), or the cause may be unknown ( idiopathic motor urgency ).

If pathological contractions are not detected during filling cystometry, but in this examination there is increased pressure in the bladder on the basis of reduced bladder capacity or symptoms of urethral instability (significant changes in pressure in the urethra), urine leakage is caused by a micturition reflex triggered by premature stretching of the bladder wall. We are then talking about sensory urgency in hypersensitive detrusor. The causes are based on the involvement of the wall by inflammation, tumor, lithiasis, or they may be unknown ( idiopathic sensory urgency ).

Related Articles

 * Overactive bladder
 * Urinary incontinence
 * Nocturia
 * Polakisuria
 * Radiodiagnostic examination of the urinary tract
 * Stress urinary incontinence
 * Urgent urinary incontinence

Recommended reading

 * MARTAN, Alois, et al. Urinary incontinence in women and its medical treatment: a guide for the attending physician. 2nd edition. Prague: Maxdorf, 2006. 83 pp.  ISBN 80-7345-094-1.