Urinary Incontinence Trivia Quiz

Answer: Muscle weakness

The majority of people with urinary incontinence are women, primarily as childbirth weakens the pelvic floor muscles. Old age in turn, including the menopause, brings in both weakness and other age related problems which can affect the time you can wait once you feel the urge to go.
Alcoholism and an enlarged prostate can both cause it as well, but childbirth related muscle weakness remains the most common cause.

Answer: Diazepam

Diazepam, being a muscle relaxant, can have the same effect on the bladder for high doses or sensitive people. Imipramine is an antidepressant which also can be used to treat incontinence, as can oestrogen cream applied externally. And antihistamines have no effect either way, although stopping someone sneezing would create one less cause indirectly.

Answer: Shock

Stress incontinence is the commonest type as caused by a weakening of the pelvic floor and mainly affects women after childbirth. Urge incontinence is more common in old age where the ability to hold the urine after the urge is felt is lost to some degree. Overflow incontinence is the least common, where the bladder becomes full and starts leaking.
You may well have an accident due to a severe shock but it is not a disorder, rather a natural reaction.

Answer: Dilation and curettage (D and C)

A D and C is actually used to scrape tissue from the uterus via the cervix, usually for a tumour. Retropubic suspension is used for a prolapsed bladder, a suburethral sling is used for a prolapse or to tighten the area around the urethral sphincter, and bulking injections reduce the size of the sphincter by adding inert material under the skin.

Answer: Running

Only exercises targeted at the pelvic area will improve muscle tone there, so running, cycling and using the gym won't make any difference to help. Pelvic floor exercises for muscle weakness, called Kegels, have to be done in the exact way they are taught or they will not work. Electrical stimulation is used in stubborn cases to contract the muscles, and vaginal cones are held in the vagina to increase muscle tone.

Answer: Yes

Timed visits are part of initial treatment for many, especially those with urge incontinence. It creates a more regular routine, and means people can go before it may be too late, rather than wait till the urge is felt.

Answer: Too much coffee

Although coffee is a diuretic, so drinking too much will make you go a lot more frequently, it shouldn't cause incontinence if you are otherwise healthy. The others are all pathological causes where normal urinary function can be impaired.

Answer: As a last resort

There is a regime for treatment of all but the worst physical causes, starting with exercises, fluid regulation and toilet planning. These alone can solve many cases, with medication or electrical stimulation of the sacral nerve used next. Conventional surgery is used if these don't work or there is physical damage, and if that doesn't work then bulking injections are used. One reason is they only last months or a few years at most so not a permanent solution and have to be repeated when they wear off. They fill the tissue around the sphincter with inert material to tighten the urethral area.

Other similar treatments include urethral inserts, which are placed surgically to reduce the size, removable pessaries which provide support from the outside, and the modern panacea, Botox.

Answer: Congenital deformity

Although all these could stop a child learning to go to the toilet voluntarily, a congenital deformity such as spina bifida is the commonest reason children do not gain this ability. Many cases can be corrected with surgery. Toilet training can be done at any age (believe it or not the UK rules have changed, and now children are allowed to start school at 5 even if still in nappies/diapers). Mental retardation would only cause incontinence if severe, otherwise it could delay training.

Answer: Women over 50

The combination of childbirth, the effects of menopause and aging of the organs directly and indirectly controlling urination mean women over 50 most commonly suffer from secondary (ie after learning to control it) incontinence of some degree. As pointed out, most cases are treatable so it is not a disaster, but she may have to try various methods before some degree of success is found.

Everyone is more likely to become incontinent with age as both the deterioration of the organs and brain affect urination anatomically, as well as the mental and physical response to the urge. But, with the existing physical differences, women have the head start from childbirth, the menopause and simply not having an external safety valve as a final barrier, so it occurs earlier and more frequently overall.