What is the difference between genuine urinary incontinence and pseudo urinary incontinence?

Written by Chen Feng
Urology
Updated on February 02, 2025
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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 Zhou Yan
Geriatrics
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What causes urinary incontinence in the elderly?

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 Chen Feng
Urology
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How to care for incontinence-associated dermatitis

The care for incontinence-associated dermatitis primarily involves keeping the affected skin clean and dry. It is important to avoid skin contact with urine as much as possible. If the skin does come into contact with urine, it should be washed promptly and kept clean and dry. If there is itching or discomfort at the site of the dermatitis, topical corticosteroid ointments may be used to alleviate the itching. Some patients might also develop infections, typically bacterial, which can be managed with antibiotics. For patients with recurrent dermatitis, considering bladder fistulation or other treatment methods might be necessary to prevent skin contact with urine.

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Written by Chen Tian Jing
Colorectal Surgery
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Can fecal incontinence be recovered?

If fecal incontinence occurs, the first step is to identify the main cause of the fecal incontinence. If it is caused by relaxation of the anal sphincter and anal canal, then surgery can be performed to tighten this area, specifically through an anal tightening procedure, which can restore control over fecal incontinence. If the patient has other underlying diseases or is elderly and frail, accompanied by changes in the nervous system, the symptoms of fecal incontinence may be alleviated through medication or physical therapy, but complete recovery is unlikely. This is because the recovery of the nervous system requires the integrated regulation of other bodily organs and functions. If there are multiple underlying diseases or if the patient is elderly and frail, especially in the later stages of coma, recovery is difficult.

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Written by Wang Shuai
Urology
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What are the characteristics of the various types of urinary incontinence?

There are several types of urinary incontinence, common ones include stress incontinence, urge incontinence, overflow incontinence, and true incontinence. Stress incontinence, which is common in clinical practice, primarily occurs in women, especially in those who have given birth, are obese, or are elderly. It is characterized by the involuntary leakage of urine through the urethra during coughing, laughing, or sneezing. Urge incontinence, often seen in acute bladder inflammation, usually presents with symptoms such as frequent urination, urgency, painful urination, and pain in the lower abdomen before the onset of incontinence. Overflow incontinence is more common in elderly men, caused by urinary obstructions, such as those resulting from prostatic hyperplasia compressing the urethra, leading to urinary retention. In this case, the patient's bladder area may exhibit significant distension and tenderness. True incontinence is often seen in cases of neurological damage, such as from spinal injury or intracranial disorders.

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Written by Zhang Hui
Neurology
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What to do about urinary incontinence in dementia in the elderly?

Dementia in the elderly is a degenerative neurological disease, and there are currently no particularly effective treatments. In the later stages, it is very common for the elderly to experience urinary incontinence. This is mainly because in the later stages, the autonomic nervous system is affected. Damage to the autonomic nerves leads to dysfunction of the sphincter muscles, resulting in urinary incontinence. Currently, there are no particularly good treatments for urinary incontinence caused by dementia, but some common methods are as follows. First, it is important to kindly remind and encourage the elderly to go to the bathroom frequently, asking every one to two hours whether they feel the need to urinate, which can help avoid urinary incontinence. Second, bathrooms must have conspicuous signs that are prominently placed to help the elderly locate the restrooms easily. Third, when necessary, the elderly can be given diapers to wear to avoid embarrassment from wetting their pants. Also, it's crucial to provide psychological comfort to the elderly and avoid causing them excessive psychological burden. Additionally, other causes must be ruled out. If there is a urinary tract infection or some other urinary system disease causing the incontinence, treatment of the primary disease should be undertaken.