Urinary incontinence pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Pathophysiology

Continence and micturition involve a balance between outlet (urethra) and bladder detrusor muscle activity. Lower urinary tract function is often divided into filling and voiding phases. Normally as the bladder fills the detrusor is compliant - stretching and increasing the volume it holds - without any unpleasant sensation and the outlet is closed. At a socially acceptable time and place to void the bladder (detrusor) contracts and the outlet relaxes and flow ensues. Any perturbation in that balance can lead to voiding dysfunction or incontinence. Abnormal detrusor muscle activity or hypersensitivity of the bladder can lead to urge incontinence. An incompetent outlet can lead to stress incontinence. A bladder that cannot contract may lead to overflow incontinence.

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